Solicitor James Bagby suffered a heart attack while out running, but the traumatic event went on to save his twin brother's life.
The 47-year-old, from Wrexham, was out for a 10-mile run on the first morning of a two-week family holiday when he collapsed on a very hot summer's day.
A nurse who happened to be passing performed CPR at the side of the road and he woke up in hospital two days later.
And when the cardiologist who treated him heard James has an identical twin brother, Jon, he asked to see him too.
Consultant preventative cardiologist Dr Scott Murray, now practicing at Venturi Cardiology, carried out a series of tests, including a CT scan of the heart - which allows doctors to see if disease is present. And the test revealed that Jon had an identical blood vessel issue as his brother.
James said: "On the first morning of a two-week family holiday to our favourite place in Porthmadog in Wales I decided to go for a 10-mile run.
“After completing the Paris Marathon earlier in the year, I was in training for the Dublin Marathon and a quick run along Black Rock Sands seemed like a good idea.
“I left my wife Paula and two young daughters Hannah and Sophie at our caravan, programmed my smart watch with a running route and set off. I wasn’t expecting to be out for long."
But it was a very hot day and James was eight miles into his run when he collapsed.
“When I got to the beach the tide was in so I had to run a different way, which took me up a big hill. I was 8 miles into my run and remember it being a very hot day. It was so hot that I later learned that two servicemen had died on training exercises in the Brecon Beacons that week," he said. “I don’t remember much of what happened next because I only woke up in hospital two days later.
“At some stage while struggling up the hill, and very dehydrated, I collapsed at the side of the road. I don’t know how long I was lying there before I was spotted.
“But I was incredibly lucky because Charlotte Haywood, a trainee nurse at the time from Malpas, just happened to be heading home after camping overnight on the beach with some friends when she recognised I was in serious difficulty.
“My breathing was very shallow by this stage and then I suddenly stopped breathing altogether. She knew what to do. While she carried out emergency CPR, one of her friends called for help.
“Paramedics defibrillated me and got my heart going then an air ambulance flew me to Bangor Hospital where I spent two days in an induced coma."
Back at the caravan, Paul was frantically wondering where her husband was and called the police after hearing the air ambulance landing nearby.
“She was told that they had collected a man fitting my description and to wait to hear more. She feared the worst," said James. “And with good reason. Although it was initially unclear what had caused my cardiac arrest – doctors initially thought my heart had just stopped and I might need a pacemaker fitting – once I was transferred to Liverpool Heart & Chest Hospital and into the care of Dr Scott Murray, he put me through a further barrage of tests.
“He carried out a CT coronary angiogram, an invasive angiogram with ultrasound inside the artery to look at my plaque and a detailed MRI scan.
“Dr Murray explained to me that as heart disease progresses, the level of plaque and calcium in the vessel walls increases, so it can be an excellent indicator of disease and can be seen very well on CT scans.
“My blood tests confirmed that I had high levels of bad cholesterol which had a role to play in why I had plaque inside my arteries. Running on such a hot day, exacerbated by being dehydrated, had caused a little bit of plaque to break away and to stop my heart.
“I was prescribed an ACE inhibitor (angiotensin-converting enzyme medication), a high dose statin and aspirin and, after two weeks in hospital, I was sent home to convalesce. I didn’t actually need a stent as the residual narrowing was not severe enough.
“My life had been saved but that wasn’t all. When I told Dr Murray that I was an identical twin he wanted to check my brother out too."
Jon, who was living in Turkey at the time with his wife Tamasin and his six-year-old son Isaac, was a keen runner like James and was fit and well.
But Dr Murray wanted to see him and carried out the same sort of heart health checks he’d done on James – everything from an electrocardiogram (ECG) which checks the heart’s rhythm and electrical activity, an echocardiogram (echo) which checks the pumping function and valves of the heart and blood tests to a cardiac CT test.
The results were life-changing.
James explains: “It turns out that Jon and I both share a faulty gene that can’t handle bad cholesterol very well, which results in a build-up of plaque in the arteries, and that he was equally at risk of a cardiac arrest, which could happen at any time.
“His ‘bad’ LDL cholesterol level was very high, at eight – anything above 3 mmol/L often leads to statins being recommended - and there was a 51% plaque blockage in his arteries, similar to my levels, and putting him at high risk of restrictive blood flow to the heart, which increases the risk of a heart attack. He had no symptoms.
“What I had gone through was bad enough, but hearing that my twin was equally at risk of the same thing happening to him was dreadful.
“I’ll always remember Dr Murray’s words when he said, following all the tests, that Jon was in a far better position now because he knows he has got a problem and something can be done about it. More often you don’t know there’s something wrong until you are in an ambulance on your way to hospital, like me.
“Like myself, Jon’s now on statins for life to reduce the level of cholesterol made from his liver, an ACE inhibitor and a daily dose of aspirin. We both have annual blood tests, we’re careful to eat healthily and if we go for a run we always take our phones and make sure we’re trackable.
“I’m so thankful to everyone who helped to save my life and I’m incredibly grateful to Dr Murray for saving my twin brother’s life too.”
Dr Murray, of Venturi Cardiology, said: “The investigation of asymptomatic but potentially vulnerable atherosclerosis is not yet a major focus for clinical cardiologists.
“But after learning that James had an identical twin brother, who was also a keen athlete, we thought it was important to carry out a series of investigative tests.
"Forewarned is forearmed and it is great to hear that this has been sustained and they are both still well to this day.”
To get the latest email updates from WalesOnline click here.