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Casillas and Puyol had tweeted about being gay, which the Spanish media has reported as reaction to rumours.
The world cup winner left football twitter baffled with his mysterious tweet that was deleted an hour later.
He had suffered a heart attack during a training session last year and has not played any competitive football since April, 2019.
The former Real Madrid skipper had called time on his five-year spell with side Porto in July after his contract with the Portuguese club expired.
FC Porto said Casillas had suffered an "acute" heart attack during training, but that he was stable in hospital and "the heart problem has been resolved".
Sara Carbonero, with whom Casillas has two children, announced via her Instagram page that she had undergone successful surgery on ovarian cancer.
The Spaniard thanked medics at the hospital in Porto as well as the thousands of people who wished him well.
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