How Nick Isiekwe fought back to the England squad after heart operation

But a groundbreaking operation, which required his breastbone to be split open, saved his career and enabled him to represent England again and win the Premiership with Saracens in 2023.

However, despite his remarkably quick return, he says it took time psychologically to recover from the procedure.

“[At the time] you just treat it as if it is an injury and you don’t realise how big it is,” Isiekwe said.

“It was kind of like [starting again]. I didn’t expect to have to start again but I have had to roll with it and I feel like I’ve got to the point now I wanted to get to.

“It was difficult but I think there is something beautiful in the struggle.

“I had it in the back of my mind for quite a long time. But now I feel completely normal – and I don’t have any reservations.”

Isiekwe was a late call-up to the England squad for the summer tour of New Zealand following Charlie Ewels’ suspension, although he did not make an appearance – with George Martin and Maro Itoje starting the two Tests against the All Blacks.

“In the summer I had a few things I needed to work on, from a physical point of view,” he added.

“But I used the summer to really get right and really push it. I feel great.”