Help to move on

Hi

I had a mild heart attack in June 2016. After an angio I was told there was no heart damage, blocked arteries or valve issues. What I did have was PAF. I had a very difficult year last year so put my heart palpitations down to stress. My breathing was really poor and I was constantly tired. The heart attack came as a complete shock. My cardiologist said it was most likely caused by an embolism due to the AF. I am on medication to control my heart rhythm, blood pressure tablets and aspirin. I do not fit the criteria for blood thinners. My general health is so much better but I am struggling to move on. Are there any other AF sufferers who have had a heart attack due to AF and have found a way to live without fear of a repeat episode?

18 Replies

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  • Lorbin welcome to the forum. A great source of support as I am sure you will find. I have not had a heart attack and am sorry to hear you are feeling this way. I can say though that a coronary care nurse once told me that after heart attack, it is a really common phenomenon that people become very fearful of having another heart attack and can sometimes start to interpret sensations in their body and fear it is a heart attack. She said it takes a while to get over the emotional trauma which is natural and understandable when you have been so vulnerable to your body. What about getting some Cognitive behavioural therapy or Acceptance and Commitment therapy or seeing a health psychologist to help with your thought patterns. You could speak to your GP about how and what services to access. Now that your AF has been diagnosed and your health is monitored you will be at much lower risk of anything adverse happening. Try and look at the facts instead of letting your thoughts run away with you. Although my condition is different to yours, I too have regular fears and let my thoughts control me sometimes. I was diagnosed with long QT at one stage a couple of years ago.. It was discovered Completely by chance. My specialist told me I could have had a cardiac arrest. It was because of a drug I was on. Sometimes in the dead of night when I feel anxious I start to worry that I might have long QT again and that it just hasn't been diagnosed. Fear can just be unending if we don't take control of it. But it stops me from living my life right now when I get excessively anxious and it steals away the joy of today making me worry about tomorrow and things that don't even exist. That is why I think this forum is great, along with friends I have met through it and my own family and friends. I have been for Acceptance and commitment therapy (ACT) and found it really good. I would advise if you do this though, to make sure you get a CBT therapist who is accredited to ensure that you have CBT with a skilled professional. Best wishes and it is great that you feel physically well:)

  • Thank you. I think my main concerns is that they don't really know why I had the heart attack and as there appears to be no damage to my heart and having a raised d-dimer level on admission the most likely cause is an embolism due to the AF. Its all the uncertainty around cause that sits in my mind. I'm back working full time which has helped me and the medication appears to be doing the trick. I think I'm a bit if an anomaly and they really don't know

  • Simply treat your body with respect and that should go a long way to alleviating your stress. Not everything can be diagnosed that happens in our lives by the medical services. I have found that having no answere to a problem can create a problem of uncertainty, within ourselves, uncertainty as to why something has happened, tends to lead us to looking for answers. Do your best to see the good In your coming out of a bad position, the positives are massive. On the start of my reply I said to look after yourself more or less, this puts you ahead with your health as you now more than ever have the insight as how important that is. Start enjoying your life again, try to look upon your experience of a full recovery as a 2nd chance in life. Best of luck, Be Happy.

  • Thank you - I know my position could be far worse. I know what signs to look for and I've been told my heart is good I just have to believe I can live a happy life - your mind is a funny thing though as I have learnt! If this hadn't of happened to me and I was reading these posts I'd be saying just get on with life you silly woman but when it does happen to you everything changes but as you have said not everyone gets a second chance :)

  • There are a number of points here most of which I fully understand although one could argue the case for anticoagulants.

    I haven't had a "heart attack" as such but I did arrest during some treatment in hospital and still have the cracked ribs to prove the CPR they used to get me back. Doctors keep telling me how traumatic it must have been for me but I tell them I wasn't there at the time so no. It was their "oh shit" moment not mine! Maybe I'm odd but the past is behind me now and the future is an exiting new chapter. OK I seem to have spent most of my life lurching from one crisis to the next head down and charging like a drunken rugby forward but I have enjoyed every moment.

    Your AF treatment seems to be on track and don't forget that your event occurred before you were being controlled. AF is seldom a cause of heart attack but heart attack may well cause AF in some cases. Since your angiogram (like mine) was clear then you are no more at risk than the average person.

    Please don't waste your life worrying. What will be will be and what finally gets you will very likely be nothing that you expected. Just look around the world and as Private Frazer (John Laurie ) would say "We're all doomed"

  • Thank you. I think I sit in the 'who knows what went on with you' pile. I didn't tick the boxes for being at risk of a heart attack, I don't fit the criteria for blood thinners so wasn't put on them. I have been told the side effects and risks need also to be considered and the decision made not to give me anticoagulants just aspirin. I have been discharged by my cardiologist which should be a positive?

  • My father had a heart attack at age 64 and passed away at 94. There was no clear explanation of why it happened to him at 64. He had injured his arm a few days before but was otherwise healthy and had no heart disease.

  • Welcome. I don't understand why you're not anticoagulated.

  • Hi, I did not meet the criteria other than being female. They also 'think' the heart attack was caused by an embolism due to the raised d-dimers on admission, finding I had PAF and no blockages or other issues with my heart. This is part of my concerns as they just don't really know what happened - I am not complaining about my care I've had numerous ECGs, echos, x-ray, CT scan, angio etc. My cardiologist told me the main concern is controlling the AF which the medication appears to be doing

  • I had a suspected heart attack while in PAF, diagnosed by rising troponin levels (d-dimers are a new one!) but an angiogram didn't show anything. I wasn't on an anticoagulant at the time though I should have been, and afterwards I felt very shocked and fragile and frankly angry with my GP who I felt hadn't looked after me, though that was unfair because like you I had put off complaining about warning symptoms. Only saying so you know you are not alone with your feelings. There are theories but so far no one has found the reason why some people (mainly women) can suffer from heart pain although their main arteries are clear and as you say living with the 'why' adds to the fear.

    I think Vony's advice is very good, the only thing I could add is that I have found the British Heart Foundation website an excellent source of information and advice for any heart issue. In this month's Heart Matters magazine which you could read online if you sign up (free) there is an article about the psychology of recovery.

    Best wishes

  • As part of routine test in preparing for my ablation, an angiogram report said I had "unobstructed coronary artery disease". What? Unobstructed? It was explained that this HS been undiagnosed in woman for ever and is the leading cause for women to not get diagnosed properly with heart disease. Men usually have "obstructive" and then can have a stent or bypass. This was eye opening for me since I new my heart was not good besides having afib and my mother died after several heart attacks but was told she didn't have heart disease. Hopefully docs will look at us women more seriously and not compare to men's heart issues as much.

  • I agree although I have also had an angio which was normal with no findings? Its very concerning as it surely must have been something?

  • Many thanks. I too had very high troponin levels on admission to hospital. I was also told on discharge my d-dimer levels were raised indicating a blood clot hence my cardiologists probable diagnosis. I have now been discharged by my cardiologist and under the care of my GP. For me its now a case of wait and see. If I feel I'm starting to get palpitations I need to go back to the GP to be referred back to the cardiologist?? I feel as if I have been cut lose and making a fuss but thinking of asking my GP for some advise re CBT

  • Hi Lorbin - I am sorry you had this experience it must have been quite a traumatic one which many people find they take a lot of time to recover from any experience they think of as life-threatening, especially when it comes out of the blue.

    You ask the question why? Then you give yourself the probable answer - it would have been an embolism thrown by the blood pooling during an AF episode. You are left feeling bewilderd and need reassurance which you are obviously not getting.

    May I suggest you first sit down and write down all the questions you have such as the last one - what would I do if I feel I have another episode?

    Many of us on this forum have many, many episodes without consequence and I don't worry at all about them but then that would be because I have had too many to count without serious consequences, although I have been hospitalized a few times. But we are mostly taking anticoagulants which gives us some protection against throwing a clot, which is the biggest risk with AF, so I think you have a genuine concern and you need an action plan if you have further episodes. I would also question if aspirin really is a good idea for AF - you may want to research this yourself. There are other drugs which may be a little gentler which is why I think it would be a good idea to consult an EP.

    May I suggest that you go to the AFA website and download all of the information leaflets so that you go to your GP fully informed.

    Is there an Arrythmia support group near you? Again info on the AFA site but also ask at your local hospital if there is an Arrythmia Clinic and an Arrythmia nurse and if so please can your u have their contact details - someone to ring and ask questions of.

    Was the cardiologist you saw a specialist in the electrics of the heart - an Electrophysiologist? If not it may be worth asking for a referral to one for on-going management. GP's are not always up to date with the latest thinking on AF and I have found that neither are some cardiologists. Again there is a list on the AFA website.

    May I also suggest you stop asking yourself why? After all why not? The real question is how can you you get back to some peace of mind and start recovering and living your life again. I suggest some emotional support firstly along with talking to others who also have the condition - such as you are doing here - and then looking at doing a daily and it does need to be daily - relaxation/meditation routine,

    This is such a supportive and friendly group so read the threads and contribute and keep posting.

    You can try your GP for CBT but I would be really surprised if you get help without a very long wait - but there are plenty of free resources on apps or on-line . I know a lot of people on here use Mood Gym - link from here mindcharity.co.uk/the-mind-...

    Much love CD.

  • Hi and thank you. Yes the cardiologist I was under was the expert on electrical disturbances of the heart. He also has quite a concern around the amount of medication patients are generally expected to take without any proven benefit. The honest answer is that they just don't know for sure it was an embolism that caused the attack but are going with I have PAF, my d-dimer levels were raised on admission (indicating a blood clot) and that my heart was clear of any blockages. I do not fit the criteria to take anticoagulants and that taking these is not an easy answer either. I do believe the attack was linked to my PAF so I need to be very aware of what my body is doing and return to my GP should my symptoms return - which I will. I will also have a look at the link you have suggested :)

  • If this was me I would want to query the statement that 'You do not fit the criterion for anticoagulants'. I have just looked at the CHADS2VASC scoring system, and it gives +1 for Vascular disease which includes MI ie heart attack.

    If the 'heart attack' was 'caused' in some way by the presence of a blood clot then anticoagulation sounds very important (it exists to prevent those blood clots!) - and would give you the confidence that the chance of a repeat episode would be very, very low indeed.

    (Also my impression is that whether you take an anticoagulant or not is ultimately your decision - so if you want it, ask your doctor)

  • Ask for an appointment with an EP. At worst nothing changes, at best it's a second opinion and new insight. Personally I didn't fit the criteria but pushed for anticoagulants. Later it was thought I might have had 2 TIAs that had never been diagnosed so stayed on anticoagulants even after "successful " ablation.

  • I will speak to my GP about referral - thank you :)

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