At 49, Warren was told he could die at any moment. A decade later, he almost did
Sydney running coach Warren Williams was a fit and healthy 49-year-old when a chance request during a visit to his GP turned his life upside down.
Williams, who started running in his late teens before taking up triathlons at 21, had taken his then-teenage son to the doctor when he asked for a check-up.
Despite telling him he didn't need one, Williams insisted, but as soon as the doctor placed his stethoscope on his chest, everything changed.
"He said, 'Your heart is going nuts!'" he recalled.
After performing an ECG on the spot, he arranged for Williams to see a cardiologist in Sydney's Randwick that same afternoon, where he was diagnosed with atrial fibrillation (AF) and atrial flutter.
According to Victor Change Cardiac Research Institute, AF is a disorder of the heart's electrical activity, whereby the heart beats irregularly, often fast. It can lead to stroke, heart failure and death.
Meanwhile, atrial flutter causes the top chambers of the heart to beat faster than the lower chambers, and can lead to a dangerously high heart rate.
His cardiologist suspected excessive training had caused the conditions, which are sometimes found in elite athletes.
Despite having no obvious symptoms, Williams and his wife were told he could die at any moment.
Williams was booked in the next day for a cardioversion, which saw doctors use a defibrillator to shock his heart back into normal rhythm.
"When I woke up there were burn marks on my chest and back where they made a couple of attempts on the front before flipping me over," he said.
Within hours of arriving home, his heart rate became irregular again, so the cardiologist decided to treat Wiliams with medication, including beta blockers, to slow down his racing heart, and blood thinners, but they left Williams barely able to function.
After three months, he was referred to another cardiologist, who took him off the medication and instead fitted him with a heart rate monitor.
Within days, Williams felt better, and was able to resume running. After five days of monitoring, he handed the monitor over for testing and was on playground duty at the school where he worked as a woodwork teacher when his phone rang.
The monitor had shown his heart rate was "all over the place".
"There were these long stoppages of 11 and 12 seconds. I was completely unaware it was happening," he said, adding the monitor also showed his heart rate was dropping as low as 15 beats a minute while he slept.
"They said, 'You need to go to the hospital. We are sending an ambulance'."
Williams instead called his wife to take him to the hospital, where he was told he needed a pacemaker.
"I argued with them for about five minutes, but there was no argument - I had to get it," he said.
With the pacemaker in place, life returned to normal.
He underwent a second planned surgery in 2019 to replace his pacemaker after the battery started to run low.
Over the years, Williams juggled family life with his work as a teacher, performing in a vocal group with his two brothers, producing artworks, running his own running coaching business, and training and competing in events.
Years passed without incident until 2021, when Williams stepped up his training ahead of a run to mark his 60th birthday that year.
The month before his birthday, he was running with a group of friends one morning in Sydney's Clovelly when he decided to see how far he could push himself.
"I thought I would smash them by running ahead up this big hill," he said.
"I was running 100 per cent when I stopped and turned around to see where they were. I remember seeing my reflection in the bus shelter and then everything went completely black."
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WIlliams came to about a minute later, surrounded by the worried faces of his friends, who had already called an ambulance and were about to commence CPR.
Despite being covered in blood from where he had hit his face and the back of his head when he collapsed, he insisted he was fine and ran the 3km back to Centennial Park.
It was only later that day when he was back at home that he decided to call his cardiologist, who suggested he go to hospital so technicians could check the data collected by his pacemaker.
"I remember seeing my reflection in the bus shelter and then everything went completely black.
"The technician came out and just said 'Oh my God'. He then got the cardiologist, who got the surgeon."
Williams was told his heart rate had reached an astonishing 300 beats per minute before he suffered a massive cardiac arrest.
Even more astonishingly, he was without a heartbeat for one minute before his heart started beating again - without any intervention - something that baffled doctors.
He was rushed in for an angiogram that showed he had suffered a rupture to his left anterior descending artery - the largest of the coronary arteries, which is crucial for supplying blood to the heart.
"It is almost always unsurvivable," Williams said, "They call it 'the widow-maker'."
Williams' artery had collapsed onto itself, creating a blockage that saved his life.
Just how his heart started beating again remains a mystery, even today.
The following day he underwent surgery to insert a stent. Somehow, his heart and heart muscle had escaped damage - something that was equally baffling to doctors.
"They were in disbelief," Wiliams said. "They still don't know how I survived [the cardiac arrest] or how I came out of it with no damage."
Williams spent the next 13 days in intensive care while medical teams came up with a plan.
They recommended fitting Williams with a new combined pacemaker and defibrillator that would shock his heart if it happened again.
Williams, who at first resisted getting a defibrillator, ended up undergoing four separate procedures, and faced more bad news.
His cardiologist, who up until then had supported his endeavours, told him he would need to give up running and sell the bike he had just bought to compete in triathlons.
"I was pretty much told the best I would be able to do would be go for a walk," he said.
But by the time he went for his check-up a month later, he had resumed running, although he did eventually agree to some concessions.
"My doctor did say to me, 'Do you really need a medal for being the fastest 60 year old?'" Williams recalled.
"My outlook has definitely changed.
"I have won hundreds of medals. Now, I run for the enjoyment, not to win."
His decision also stemmed from his family, including wife Tracy, daughter Larissa, 36, and son Jordan, 31, who are all keen runners.
"My family have had to go through this as well," he said.
"I talked to my wife about it. She has had to live with the fear of something happening."
Nowadays, Williams, 64, runs recreationally and when training runners at the family-owned business The Run Squad.
But Willams no longer tries to keep up with the fastest runners, and prefers to run alongside his daughter when she is competing in half marathons, instead of racing on his own.
He is also committed to raising awareness of heart disease - which is Australia's leading cause of death - and supporting others who have been diagnosed with heart-related conditions.
He has been an ambassador for The Heart Foundation and Victor Chang Foundation, and is often called on to talk to others diagnosed with a life-changing heart condition.
"When I was first diagnosed, it was a massive shock," he said, noting he was depressed when he first received his diagnosis.
"The first couple of weeks I was not able to do any exercise and I was worried that I was never going to run again."
He is now taking his role a step further by joining the Heart Research Institute's new consumer program.
It allows Australians living with heart conditions to offer their 'lived experience' to researchers and to help guide the science that treats a range of heart problems.
"A patient's lived experience with cardiovascular disease helps make medical research more impactful and relevant," according to the Institute's scientific director and cheif executive Professor Andrew Coats.
"Consumers offer our scientists valuable perspectives that researchers alone may not see, such as how a condition affects everyday life, their families and communities."
Williams believes the program helps doctors understand there shouldn't be one generic approach to treatment, referencing his example of being prescribed medication that made him feel worse.
He also encourages everyone over 40 to see their GP for a check-up.
"No matter what your health condition is or how fit you are, once you turn 40 I think it's a good idea to have your heart checked if you are partaking in strenuous exercise," he said.
Every Wedneday, Williams runs up the same hill where he collapsed and on each anniversary he stops for a photo at the spot where he almost died.
"There is a fear every time I run," he said.
"But it is a pretty good way to go and I would be doing something I love."