To go or not to go

Of course you will all know I am referring to A&E After a nine month break and foolishly digging the garden thinking I could now do this sort of thing, I was brought up sharply on Friday evening after doing this by a full blown AF attack. I am very symptomatic and immediately the chest pains started and I felt faint. My doctor had given me digoxin to take as a stat dose of 500mcg should this happen However I know this takes a few hours to work. Stuck it out for a couple of hours of 140 to 160 bpm but decided for peace of mind and professional care to go to the hospital. We did this and after all the usual tests and wonderful care by the nursing staff and further digoxin and bisoprolol it finally resolved itself at 9am. My only complaint is that once again the duty doctor in the morning insisted that the pain I feel is indigestion and prescribed omeprosol. I have had pAF for six years now and certainly know the difference between the two type's of pain. I have come across this before when having AF and it is very frustrating. It makes one feel as though you are fraud!! Has anyone else had this sort of thing happen to them?

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  • This does surprise me but then again many A and E doctors are overworked and stressed. My own experience is diametrically opposite in that my own diagnosis of indigestion (it had been a wonderful curry) was rejected and a full bank of tests carried out before I was finally allowed home. I think the problem is that pain with AF is relatively rare (cue hundreds of letters refuting this) so it is often rejected.

    Once again it is almost a requirement of having AF that we become experts at our own version of this mongrel condition.

  • In my opinion, you did absolutely the right thing. As an AF'er you know your body and your symptoms. Chest pain, fainting is a clear indicator of a need for A and E. In my experience, if I have gone to A and E they have been fantastic and always said I was right to come in. I have never met staff not wanting to help only staff way too busy to be able to fully.1

  • Thank you Richard My concern is that we are threatened with the closure of our A&E in Oxfordshire and I dread that happening with my condition

  • Sorry to hear you have had a bad af attack and I endorse your description of attack as opposed to episode because it feels like an attack when you are very symptomatic like you, as am I.

    I dont know what it is to have an af attack without chest pain and intense pain at that spreading to arm, jaw, even calf and under my feet, horrendous, plus of course almost fainting every few seconds until the attack is over.

    So yes, a and e very appropriate. Problem is they aren't cardiologists and I found when in the south west and needing hospital care they were quick to take me off my bp meds for some strange reason which sent me into all sorts of symptoms non af related which took ages to settle. Although my EP is not in my home city I have found when needing a and e locally they have always called someone down from cardiology to deal with me.

    Better safe than sorry when symptoms are dramatic and any medic would expect you to attend a and e I suspect In those circumstances. My GP called an ambulance once when I was in their surgery and went into af and in reality it was a non af event at that point for me indeed I was only just starting into it but I was whisked off pronto.

    An EP speaking at a cardiology seminar I attended once quipped that it was best to stay away from a and e if possible as they quite often mess with your current treatment and EP has to put you back together again afterwards. Dont know if this was said tongue in cheek.

    Pleased you are back in nsr, take care, rest up and while. Be well. X

  • Thank you Meadfoot it is always such a comfort to write on this site knowing that fellow suffers know just how you feel :-)

  • You have PAF for six years and you're taking bisoprolol, a beta blocker rate control. Digoxin is also rate control. So, was rate control the one route for your treatment?

  • No I was on a high dose of Sotalol which is both rate and rhythm control but it stopped working and had also affected the ? Time of my heart. They then tried Bisoprolol and that has been working well.

  • Interesting. James Roland in "A complete List of Atrial Fibrillation Medications" does state that Sotalol (Betapace) is both a beta blocker (the rate part) and a potassium channel blocker (the rhythm part). So, I'm concluding that you are dropping the potassium channel blocker rhythm part and continuing with the beta blocker rate part via Bisoprolol. And, I've heard nothing about your having had an ablation.

    Thank you for your information because it will help me to be on top of my medications. I reacted badly to metoprolol, a beta blocker rate drug, but tolerate verapamil well, a calcium channel blocker rate drug. No rhythm drug has been prescribed for me even though I've read some who are facing cardio version are prescribed rhythm both pre and after cardioversion. My date for cardioversion is April 13, five weeks from when I saw the cardiologist.

  • Hi Kineton 38 have just read your comments -I do know where you are coming from have experienced similar reaction as yourself when visiting the hospital. I too have sufferred with the wretched af for many years but as it got progressively more invasive and worrying I have actually rung thru to the ambulance service. As many years I was employed in thE NHS service so when the crew arrive if I do apologise for calling them I am assured that I did the right thing!!!!

    I am (at this point in time) on the list with a Doctor who specialises in atrial fibrillation and I'm on her list to have an operation in The John Radcliffe Hospital in Oxford!!!! My initial appt has been made with her is 30th June. I have waited a long time for this appt so keep your fingers crossed that I will be suitable and do not have to wait too many months before this takes place. Best wishes

    Gillyflower 13

  • Thanks for reading my post gillyflower it helps when someone knows what you are writing about!! We are not far from each other as I have been to the JR myself. Live just north of Banbury. All the best 🌹🌹

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