This time, the racing heart rate was chemically induced and Sara was horizontal in an MRI machine — enduring yet another test in the hope of finally diagnosing a serious post-COVID heart condition. “I went to Stockholm to do a CMRI — it’s when you take MRI pictures of the heart while you’re stressing it with a drug that causes your blood pressure and pulse to rise. You basically simulate a training session — it was awful, so bad. You lie still and have to hold your breath, and you have a heart rate of 200 — it was crazy.” At that stage, she was desperate for answers to a problem that had not only derailed her career — it also initiated a full-on identity crisis for the Gothenburg-based athlete. “I didn’t get depressed, but I thought my life as I knew it was pretty much over. My professional career as an athlete was over,” she says. “I was thinking that everything I like to do involves some kind of activity, and I just saw that all the joyful things in life just disappeared one-by-one. I sat there trying to make a list of what I could do — and it was scary.”

Sara’s triathlon journey has long been entwined with her medical studies. It was only when she began studying that she started running, and it progressed from there. “When I got into med school, there was a group of people who were very active — some runners, some swimmers — and we started to train together. One bought a bike, then another bought a bike — and it went on like that. Then we had this local triathlon that my mother convinced me to try. I had a road bike, and I could swim, not good but ok. And it was so much fun.” That was in 2014 when Sara turned 25. Within twelve months, she was the Swedish champion.

Knowledge is a gift, but too much knowledge can be a poisoned chalice — and as a newly qualified doctor, Sara inevitably took a few long dark sips when the heart problem first revealed itself. “I try not to be my own doctor, but you still have the medical knowledge, and you can’t hide from that. In the back of your head you try and diagnose it and think of the worst-case scenarios.” So, what started as a straightforward COVID-positive got scary. Fast. “After the positive, I took some time off. When I started training again, I felt ok. But then, after some sessions, I could feel this squeezing pain in my chest. Then, it started to get worse, and I thought that I should check it out.” The resulting ECG startled her. “I looked at the results myself and thought, ‘ok, this doesn’t look good.‘” The following weeks were a blur of multiple trips to A&E, ECGs, stress tests, and, finally, the CRMI.

Eventually — after all the examinations and soul searching — Sara got some answers. Positive ones. “After the CMRI, they could see that there was a part of my heart that didn’t get enough blood — that was what was causing the pain. They had seen this with post-Covid patients and that it is usually temporary and goes away with time. I just needed to take it really easy and not push my heart. I was told to listen to my symptoms, and I could do everything that was pain-free.” Athletes tend to be impatient — and that’s true even for medically-trained ones. The temptation to get back training, to get back suffering, is immense — but for Sara, she was forced to take it slow. “Some days I could only bike super-slow — but some days I couldn’t even walk up a hill because my heart rate went up, and I felt the chest pain again. It was a real challenge to take it easy and just go by feeling all the time — you know, trying to accept that some days you can’t do anything at all.” The first real sign that she was getting back to normal happened in her home-from-home, the training paradise of Mallorca. “I remember I was there in august to do some long bike sessions, and I felt like, ‘ok, now it’s going in the right direction.‘ I still couldn’t do any intensity, but I could do long aerobic sessions.”

Think of a pendulum, hanging vertical, perfectly still — its equilibrium position. All Sara’s doubt, pain, and uncertainty from the health scare pulled the pendulum bob far and high to the left — only to be released by the news of her heart condition being temporary. The resulting swing of the pendulum was always going to be extreme — but when it swung right, it swung very right indeed. In November 2021, at her comeback race at IRONMAN Cozumel in Mexico, Sara broke the tape in 8:22:41 — which, at the time, was the fastest ever finish time for a female IRONMAN athlete. “I didn’t know the exact time. I knew it was fast because I was checking my watch, and I was like, ‘ok, if I finish at a quarter past three, it will be a good time,’ But I didn’t know it would be that good of a time!”

“There is something special about this long-distance event, about IRONMAN. It’s just something magical that gets you going...I’m not really sure I can explain.”

If the past year has thought Sara anything, it’s that you never know. The only sure thing is that her passion remains — undiminished, indomitable.

Sometimes, actions speak louder than words. The big island and Kona are calling.