Objective This article examines the relationship between microblogging and the development of health narrative through the lens of an institution-initiated media event, the first live-tweeted heart operation in the Netherlands. It specifically addresses the question, how does health narrative take shape on a microblog and other (social) media, through the combination of self-initiated status updates, reactions to questions and short conversations with followers? Methods A combination of qualitative and quantitative data analysis was used to identify prominent themes in the tweets and trace the complex process by which the narrative took shape. The results presented here are derived from the qualitative analysis. Results There are four recurring health narrative themes in the tweets: (a) new challenges to professionalism; (b) mutual exchanges of information, support and advice; (c) increasingly personal (and public) details; and (d) questions about ‘resuming normalcy’. The special nature of this case also reveals interesting features, such as the multiple narrative starting points and the phenomenon of ‘tweeting by proxy’, and raises a number of critical questions regarding this type of use of social media in healthcare. Conclusions In the discussion we reflect on whether/how microblogged health narratives are really ‘new’ and on the implications of this single case for understanding the relationship between social media, health narrative and the changing relationships between information technologies, actors and institutions. We further examine this case as an example of what Lupton has deemed the ‘digital patient experience economy’, in reference to patients increasingly being encouraged to post experiences of their illness and encounters with the healthcare system to online platforms, where these shared experiences become valorised and monetised.