WHEN Ciara Wannop began suffering chest pains and shortness of breath, she put it down to pregnancy-induced heartburn.

The 33-year-old Carlisle woman, who was 26 weeks into her pregnancy, was fit and healthy and had no reason to suspect there was anything more serious to worry about.

For three days, she endured discomfort, completely unaware of the truth.

She had actually suffered a heart attack.

Ciara later learned that what happened was the result of an inherited genetic condition she had no idea she had. After an initial assessment at The Cumberland Infirmary, nobody had any reason to suspect heart attack.

Yet the truth emerged when a blood test and an ECG confirmed that a blood clot, combined with an extremely high cholesterol level, was blocking her artery.

Within hours, Ciara was transferred to Newcastle’s Freeman Hospital. She has nothing but praise for the expert care she was given.

Ciara underwent an angioplasty - a lifesaving procedure to clear the blockage in her artery and insert a stent to keep it artery open.

Looking back at what happened, Ciara - and NHS pharmacist - said she now regards herself as 'lucky'.

“I see patients day in and day out and if I’d read my symptoms in a patient’s notes, I'd have thought: heart attack,” she said.

“But looking at the patient’s age, my age when this happened, I probably wouldn’t have thought that. Unfortunately, because of my age and because I’m relatively fit and healthy, it didn’t spring to anybody’s mind initially.”

Tests at the Royal Victoria Infirmary’s Lipid and Metabolic Clinic confirmed Ciara has Familial Hypercholesterolaemia (FH) – an inherited condition which gave Ciara an abnormally high level of cholesterol.

She was prescribed statins but unable to start taking the cholesterol-lowering tablets while pregnant or while breastfeeding her new son Odin.

Since starting her treatment, her cholesterol level has fallen to a safer level.

Since this mum-of-one’s health scare, other members of her family have undergone FH tests.

“The cholesterol had been building up in my arteries for years," said Ciara, from Scotby, who is a keen runner who has competed in the past in the Great Cumbrian Run.

“In a weird way, I’m very appreciative that I’ve had this because my sister - whom I’m very close to and is only two years younger than me - has the same genetic condition.

“She’s now had every test imaginable to make sure she’s okay and she’s on the right medication.

“Her children and my children will all have the benefit of knowing and making sure it doesn’t happen to them.”

Around one in 250 people will have FH – yet only eight per cent have been diagnosed.

As well as her sister, two cousins have been confirmed as having the condition. Ciara's dad, seven-out-of-nine of his siblings, and his mother were also taking tablets to manage high cholesterol.

She added: “I was really, really lucky and I know that in a way, I was saved by Odin because being pregnant in addition to having the blocked artery triggered the heart attack – and I wouldn’t have known I had FH until much later otherwise – when it would probably have been much worse.

“When I was having the burning pain in my chest I didn’t consider for a minute that it was a heart attack; I was fit, going to the gym and continued horse riding while pregnant; I had never smoked and ate healthily – and I was only 34. Even my doctor friends and my midwife didn’t think it was a heart attack.

“It shows that just because you are healthy and fit doesn’t mean you are safe; you could be a professional athlete and not realise you have FH and a dangerously high level of cholesterol.

“It was the worst time of my life when I was told there was a problem and it might have been a cardiac abnormality; I was worried when I was told it could be a coronary artery dissection and I would have to give birth at 26 weeks; it was very scary. When I was told it was a heart attack it was actually a relief.”

“I know that I was really lucky that FH was discovered and I was looked after in an unbelievable way, everyone was brilliant in Carlisle and in Newcastle.

“After the procedure I went for cardiac rehab in Carlisle and they had never had a pregnant patient before, there were no studies about FH in pregnancy and in providing rehab, but the cardiac rehab team were fantastic, they helped me get my confidence back to start exercising again and they kept doing check-ups and keeping a close eye on me.

“I was amazed when I discovered how many of my family were on statins; no one talked about it so no one realised there were so many with high cholesterol. Now that we know, we can get our children tested and if they have FH they will be able to control it.

“The genetic test is free in the UK so there is no reason why you shouldn’t be tested. In Ireland where my family live they have to pay for it which is why my cousins haven’t all had one yet but I really hope they do because it could save their lives.”

Sue Musson, FH Nurse Specialist with the Northern Genetics Service, said: “If you have FH it means that your level of cholesterol in the blood is double what it should be from birth.

“We can treat people from the age of 10 so that they will never suffer blocked arteries; when an artery narrows, clots are formed and these can break off and travel to the heart or brain, causing a stroke.

“Usually a person with FH is in their 40s or 50s when they have a first heart attack or stroke and then they get a test which shows they have a treatable condition.

"If they had been tested earlier, the damage and possibly death could have been prevented.

“I love my job, it is very rewarding to be able to prevent cardiovascular disease. It is sad to do a family tree and find that someone’s dad or auntie had died from a heart attack or stroke which could have been easily prevented with a statin. It is nice to be able to offer the test to younger family members and identify FH because it means we have prevented cardiovascular disease, potentially saving their lives.”

A new national programme has been launched by England’s 15 regional Academic Health Science Networks (AHSNs) and NHS England and Improvement, to raise awareness in primary care of FH and other inherited cholesterol conditions for which effective treatments are available.

The aim is to increase cholesterol testing and make the best use of lipid lowering treatment, based on NICE (National Institute for Health and Care Excellence) guidance.

Dr Joe Chidanyika, the national Lipid and FH programme manager for the AHSNs, said: “We have an opportunity to save many more lives both within primary and secondary care; undetected high cholesterol and FH are silent killers which can easily be identified in childhood or at any point in someone’s life, through a simple health check or searching GP records for previous test results in people who are at high risk of cardiovascular disease.

“As well as recommending lifestyle changes to reduce risks, we have a growing range of medications available which can control cholesterol levels and prevent the blocking of arteries that can lead to strokes and heart attacks.

“Our aim is to identify and treat many more people who are unaware they are living with a time bomb – to beat this silent killer.”