It was the last day of August 2021, a typical warm afternoon on a sandy beach in the
north of Malta. A woman was sunbathing on a sun lounger when she saw three Maltese police officers heading towards her accompanied by a hotel dive centre staff member,
“That is his wife”
…she heard the dive centre staff say to the police.
She was informed that there had been an accident and that the police wanted her husband’s passport. All four people then accompanied her to the hotel room to get the passport. She continued to ask what was wrong, and she was obviously very worried, but she did not get any straight answers.
After handing over the passport to the police, they left.
The staff member at the dive centre then mentioned that her husband was being transported by ambulance to the main island hospital and that he would immediately drive her there.
After trying to find out what had happened, the guy said that it was a diving accident,
…a rapid assent issue,
…to which she replied…
“that was not possible, as he is a diving instructor.”
The Incident
The husband was me, and I came around in the hospital in an agitated state, with intense chest pain and confusion. Initially, I was told the problem was due to a rapid ascent and that I had a suspected lung embolism. However, the truth was far more serious…
…I had had an SCA underwater.
I was found unconscious at the surface, and CPR was administered on the shore for 25 minutes. Due to the rapid assent and the fact that I had a suspected lung embolism, I had to go into the bariatric chamber. I underwent five daily sessions of 60 minutes in the chamber – the first one went drastically wrong as the full oxygen mask, which was strapped onto my face, wasn’t even turned on!
Recovery
The entire experience was a nightmare, but having our son-in-law fly over on the first available plane to support us made it more tolerable. My family was told there was no space in the cardiac ward, so I ended up spending ten days in a ward that could only be described as a geriatric one.
During those ten days, I saw four people die on that ward, and there seemed to be more security guards than nurses. I had an absolute determination to walk out of that place. I had severe chest pain even though I was assured that I had no fractured or broken ribs.
The echocardiogram showed that I had an EF of 25%. I was told that I might have to have bypass surgery, but on the 4th day, an angiogram was performed, and all was normal. On the 5th day, the bariatric treatment was stopped, and my heart was showing signs of recovery.
Despite two previous chest X-rays stating that there were no fractured ribs, the discharge letter stated that “fractured anterior process of the left 3rd and 4th ribs where again noted” and there was “No pneumothorax”.
After leaving the hospital, we returned to our hotel so that I could rest and be fit enough to fly back to England. The day before I was discharged, my wife had to travel miles away from the hospital and our hotel to the police station to retrieve my passport.
Home
When I returned home, I first called our medical centre and told them what had happened—it was now September 20th. I was referred to the cardiac unit of our local hospital. I got an appointment for the end of November, and I was still taking the medication prescribed by the hospital in Malta.
During this time, I was actively trying to gather my medical records from the hospital in Malta as we still did not have a proper diagnosis.
My EF at the end of November was 27%.
I did feel that I was making some progress, and I was given an appointment for a follow-up at the cardiac unit at the end of February—five months after the event. Not satisfied with my progress, I made an appointment with a private cardiology clinic, and things started moving in the right direction.
I was then properly diagnosed as having had an SCA, as most of my medical records from Malta had now been gathered and assessed. My end-of-February appointment was changed to the end of January, my medication was changed, and I was referred to a local heart failure clinic, which I didn’t know even existed, by then it was the beginning of March 2022 (and it is an NHS procedure that the GP should refer cardiac patients). Six months after the first EF assessment, my EF went up to 47%, thanks to exercise, lifestyle changes, and proper medication.
On The Ball
After my discharge from the heart failure clinic on September 22 (1 year after the SCA), I was seen only once by the cardiology department, and that was in March 2024, where an echo heart scan was performed, giving an EF of 40-45% (so slightly down on the 47% on the one done on April 22). It was decided that medication would remain the same, but if there were any changes, to report back to cardiology.
In May 2024, I had an “episode” of shortness of breath and dizziness when going up a flight of stairs while on holiday. This was reported to our medical centre, which gave me a thorough checkover and referred me back to cardiology. I tried to contact the heart failure clinic but was told that the referral would have to come from the GP.
It took me three months to see a cardiologist. Recently, a report was sent to myself and the medical centre advising that one of the medication dosages I was taking should be increased as, at the time of the appointment, my BP was raised (unfortunately, the information about that medication was wrong and mentioned ramipril when I had always taken enalapril).
Unfortunately, I have been left with the impression that the patients themselves have to “be on the ball” and that follow-ups are sporadic. Still, the most time-consuming and irritating thing is that you must go through the whole “process” of seeing a cardiologist or having a question answered should you feel that something might need to be looked into. I think it is most important that we remain survivors of an SCA.
Resurfacing
Only recently, I attended a workshop to create a standard of care for the NHS that could eventually be rolled out and applied to all survivors of SCAs after they are discharged from hospital.
The nice part was that co-survivors (the partners or loved ones of survivors), who seem to be overlooked now, were also included and asked for their experiences and feelings to be considered while creating these standards.
SCA UK was also involved, and my wife and I met some very lovely and caring people. I was talking to them when I realised that I was one of the lucky ones. I am told the odds of surviving an out-of-hospital SCA are around 8%…
…there are no statistics for one underwater!
At the moment, seemingly not a lot is being done to improve the 8%, and it is perhaps considered either luck, intervention in time or just “the odds”. It is about time that this be improved on, and after my experience at the workshop, I feel now that this is starting to happen, and we are now studying the causes, significance and consequences of what happened to us and our loved ones during and after surviving a sudden cardiac arrest.
I’m a scuba diver instructor who survived a sudden cardiac arrest while underwater. This life-changing experience has driven me to share my story, raise awareness about heart health, and support others facing similar challenges.
Wow, what an event! Thanks for sharing, Rob.
OMG wow what a story so glad you are still here to tell us your tale, your poor wife she must of been beside herself with worry , big hugs to you both
My husband was discharged with heart failure and A fib with no follow up. It took a formal complaint and much badgering to get followed up. 3 months to get appt in HF clinic and a further 3 months for cardiologist appt. All in all it took me a year to get the care he required so I understand your battle. Glad you pulled through.