Little update: “Rumors of my death have been greatly exaggerated”

It’s been just over three weeks since I randomly “let the Internet know” that I was heading in for unexpected heart surgery, and now that I’m starting to emerge from the fog of it all, I wanted to start answering some of the questions people have been asking, and color in what happened and where it’s all up to.

The TL,DR Version

Here’s the short version for those who just want the highlights:

I presented to the ER with a very fast, very strong heartbeat.
Previously, I’d had similar episodes diagnosed as tachycardia caused by some sort of panic attack.
When they hooked me up to an ECG, they found I had sustained ~190bpm supraventricular tachycardia (SVT) and suspected Epstein’s anomaly as the root cause.
The SVT resolved on its own, and I was getting ready to be discharged when a third doctor heard a very loud murmur. Heart issues like this run in my family, and I’ve had proactive studies in the past which showed nothing, so this was new news—a completely different issue to the SVT—and pretty concerning.
They kept me in overnight for an echocardiogram, which confirmed what the doctor had suspected: My mitral valve had failed, causing my heart to enlarge, and this enlargement was triggering the SVT.

The Longer Story

Let’s rewind to July 9th. I was driving in Sydney with my wife, Viv, when my heart started beating very quickly and very strongly. This wasn’t my first time experiencing this—it’s been a thing that’s happened occasionally over the past four years. Each time, it was diagnosed as a panic attack or stress reaction. But this time was different for a couple of reasons.

First, Viv was with me. She’d never seen this happen firsthand before, and understandably, she was pretty freaked out. Second, we were only about ten minutes away from a hospital that we knew well. While I wasn’t overly concerned about the immediate danger I was in, we figured it was a good opportunity to “catch it in the act” on an ECG and get a second opinion. My self-diagnosis of panic attacks was based on an actual medical diagnosis from a previous episode, but that was all after the fact. Capturing my heart in the act would either confirm that original diagnosis or help me better understand anything else that might be going on.

To say that this turned out to be a really good call is a bit of an understatement.

The ER Visit

On admission, they hooked me up to an ECG and found that I was pushing 190bpm in an SVT rhythm. For those unfamiliar, SVT (supraventricular tachycardia) isn’t inherently dangerous—it’s just incredibly tiring and super uncomfortable. But it also suggests there’s something else going on, as opposed to the heart simply reacting to external stressors like it does with a panic attack.

After a few minutes, the SVT self-resolved, and after about half an hour in normal sinus rhythm, everything seemed like it was back to normal. At this point, we shifted tack to talking about treatment and prevention options for SVT in an otherwise healthy 43-year-old. The options ranged from medication to minimally invasive surgery. We were getting ready to be discharged, shaken but not stirred.

And then a third doctor came by with his stethoscope.

The Hunch That Changed Everything

This doctor had developed a hunch when I first presented and wanted to chase it. He’d heard a very loud murmur when listening to my heart and decided to investigate further. Heart issues run in my family, and I’d had proactive studies in the past which showed nothing, so this was new news—a completely different issue to the SVT—and pretty concerning.

They decided to keep me in overnight for an echocardiogram, which confirmed what the doctor had suspected: My mitral valve had failed, and my heart was only operating at 21% of it’s capacity. This inefficiency had caused my heart to enlarge, and this enlargement was triggering the arrhythmia. It was the valve that was the actual problem—and it's failure was so severe that it was weeks away from causing true cardiac arrest.

That doctors hunch, and his patience to wait around to check that hunch, saved my life.

Understanding Valve Failure

Valve failure is a weird thing. It’s different from the kinds of heart failure that people are used to. Aside from being genetic and completely lifestyle-independent, the heart is designed to compensate for a little “regurgitation” (i.e., blood flowing in the wrong direction because of a leaky valve) and is very good at it. So if a valve starts to fail, the heart is designed compensate enlarging itself so that it can work harder. This compensation can mask the problem for a long time, which is a part of why in cases like mine, it goes "unnoticed" until it’s quite advanced.

In my case, the regurgitation had progressed to the point where it was off the medical scale doctors use to describe it: “Torrential” was the word they used. Essentially, my heart was working overtime to compensate for the valve failure and had been doing so for quite some time, and the built-up strain was causing these episodes of rapid heartbeat.

The Road to Surgery

Once the diagnosis was confirmed, the next step was surgery to repair or replace the mitral valve. This wasn’t a decision that was made lightly, but it was clear that it was necessary to prevent further damage and the risk of cardiac arrest.

The timing of all this was surreal. I was in Australia on a family vacation ahead of Hacker Summer Camp in Vegas. The fact that this all went down where I’d be closest to my family and extended family is one of many little miracles that dotted an otherwise fairly sucky story. I ended up having surgery at literally the same time that I was meant to be on the flight from Sydney to San Francisco.

The surgery itself went well, and I’m now in the recovery phase. It’s been a journey, to say the least, but I’m incredibly grateful for the care I’ve received and the support from my family, friends, and the broader community.

Lessons Learned

There are a few key takeaways from this experience that I think are worth sharing:

Listen to Your Body
If something feels off, don’t ignore it. I’d been brushing off these episodes as panic attacks for years in spite of a general concern that "something wasn't quite right", and it turns out there was a much deeper issue at play. Trust your instincts and proactively seek medical advice when something doesn’t feel right. Even better, if you're over 40 years old or work in high-demand job or industry, stop putting off all of those preventative checks people keep talking about. For me, continuing regular heart checkups wouldn't have prevented the failure, but there's every chance that we'd have caught it early enough to allow treatment with far less drastic surgery.

Advocate for Yourself
The third doctor who chased his hunch made all the difference in my case. It’s a reminder that sometimes you need to push for answers and not settle for the first explanation you’re given, and sometimes you need the patience to wait around to listen.

The Importance of Support
Having Viv with me during that episode made all the difference. Her concern and insistence that we go to the hospital likely saved my life. Don’t underestimate the value of having a support system in place.

Gratitude Matters
The outpouring of support I’ve received from friends, family, and even strangers has been incredible. It’s a reminder of the power of community and the importance of showing up for each other.

What’s Next?

For now, I’m focused on recovery. It’s a slow process, but I’m taking it one day at a time. I’m also reflecting on how this experience has changed my perspective on health, life, and the importance of being proactive.

I’ll continue to share updates as I progress, and I hope that my story can serve as a reminder to others to take their health seriously and to advocate for themselves when something doesn’t feel right.

Thank you to everyone who has reached out with messages of support—it means the world to me. Here’s to a healthier, stronger future.