“I was fit, but stress contributed to my heart attack”

When a fit, clean-living business executive took on the Cape Town Cycle Tour, he didn’t expect his race to end in emergency evacuation – or that he would have to relook his whole life.

Eight years ago Byron Nichles (then aged 44) flew down from Johannesburg to take part in the Cape Town Cycle Tour. From the start, it wasn’t his best outing. Early on, Byron picked up a puncture, but the friends he was riding with didn’t realise and kept going. He was pushing to catch up with them when he suffered a sudden, severe heart attack that would change his life.

Byron had none of the symptoms that would usually indicate to someone that they were in trouble. “I didn’t know I was having a heart attack,” he says. “I was cycling up Suikerbossie and apparently I just keeled over, with no warning signs.”

Lifesaving interventions

He has no memory of what happened next but would later learn how strangers rallied to save his life. “A trauma nurse and her husband were cycling behind me on a tandem, realised what had happened, stopped and administered CPR while waiting for an ambulance,” he says. This likely played a big role in saving Byron’s life.

“Starting CPR quickly makes a big difference as it keeps blood pumping to the heart and brain while seeking help for the patient to be transported to a hospital,” explains Dr Andile Xana, a cardiologist at Mediclinic Heart Hospital in Pretoria. “The likelihood of survival is three times higher if bystander CPR is initiated immediately.”

While the nurse was working on Byron, an off-duty emergency vehicle happened to drive past and stopped. “The medic resuscitated me via electrical cardioversion – twice,” he says.

“Cardioversion converts a heart rhythm that has jumped out of rhythm back to normal rhythm,” explains Dr Xana. “This can be done with medication (chemical cardioversion) or with an electric shock (electrical cardioversion).”

Realising Byron’s condition was deteriorating fast, the medic radioed for emergency evacuation via helicopter. “Apparently, I also suffered at least two seizures during this time,” Byron adds.

He was resuscitated several times on route to hospital, where he was stabilised, intubated, and kept heavily sedated for three days. Doctors inserted a stent into his heart – but this was more a precaution, as there was no indication that a blocked artery had been the cause of his heart attack. “A stent is a tubular scaffold that holds an artery open – it’s inserted where there is blockage to unblock and keep the artery open,” Dr Xana explains.

Not a typical heart attack case

Byron wasn’t an obvious candidate for a heart attack, though. He was fit, followed a healthy diet, had no history of heart disease or related conditions personally, and no family history either. “I’ve never smoked, and don’t have high cholesterol or high blood pressure,” he adds.

What he did have was a very stressful job. As executive director of a JSE-listed industrial group and CEO of its largest division, Byron managed around 5 000 staff across multiple companies locally and across the continent. In the months leading up to the race, he’d been doing a lot of international travel for business and working long hours.

“Stress can affect your heart in multiple ways,” says Dr Xana. “It can lead to hypertension, which increases risk for a heart attack and stroke. It’s also linked to behaviours such as smoking and unhealthy eating, which in turn also increase the risk of heart attacks.” Although these behaviours didn’t apply in Byron’s case, the stress he was under could have been a major factor. “High levels of cortisol produced with stress can also increase blood cholesterol and blood sugar, which in turn increases the risk of heart attack and stroke,” adds Dr Xana.

“Miracle man”

After less than a week in hospital, Byron was discharged. And while he continues to go for annual heart check-ups, he’s experienced no lasting effects – leading his medical team to refer to him as their “miracle man”.

“It’s unbelievable – I’ve made a full recovery with no damage, scar tissue or impaired heart function and no ill-effects or impaired functionality following the seizures,” says Byron. “I feel 100% fine now and I’m back on the bike!”

Looking back, Byron describes a “perfect storm” of stress, too little sleep, overexertion, and possibly dehydration that likely led to his heart saying, “no more”.

Change of pace

After the heart attack, Byron spent an extended time recovering at home before returning to work. “I thought I’d ease my way back and work differently than before. However, after a few weeks, I was working harder and longer hours than I had previously.” As a driven, competitive person, he felt compelled to prove to himself that he was fine. But he also knew it wasn’t a good idea.

“After much introspection and soul searching – and begging from my wife and my [then] eight-year-old daughter – I realised I was putting myself and my family at serious risk of an even greater tragedy. So, I resigned, and we packed up our lives in Gauteng and moved to Cape Town.”

Leaving the thrill of a high-level corporate job was a big adjustment for Byron, but he has no regrets. Today he co-owns a luxury property development business – a job that allows him to lead a much more balanced life. “I have time to exercise – mainly mountain biking – and spend time with the family. I do less travelling and have much less stress. No amount of money could ever convince me to go back to my previous lifestyle.”

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