AF Association
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Disappointed

Well finally had my appointment on Friday but never saw a cardiologist or EP just a nurse. Was really disappointed as I couldn’t get any answers to my questions. He was a really nice guy but obviously couldn’t commit to whether my gp was right or not regarding whether I had heart attack, although he said the ecg was the worst one he had seen in regard to quality. Did confirm that I was in nsr so didn’t need cardio version. I have to wear a 3 day monitor to confirm this was not a one off.

I pushed regarding what the gp said regarding need for angiogram and he said he would talk to consultant.

Am I being unrealistic as I feel a bit cheated not to have opportunity to talk to a consultant.

Think I might have to investigate down the private route as I have no plan b. No pills if I go into AF, unfortunately I only thought of the questions I should have asked when I was in bed that evening.

Apologies for long post.

Regards Deb

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That all sounds frustrating. Was it to be a cardiologist or EP, as EP's typically don't order angiograms. NP's can usually handle an office visit, though if this was your first visit you would most certainly expect to also meet the EP and have the entire team answer your questions. And only a 3 day monitor? I hope they can get clear answers, as typically a 30 day monitor gives a better evaluation. Gather your questions to take when you go to review the monitor results. Or better still email them for an answer now, if that is an option!

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I don’t think they have EPs at my local hospital but I was expecting at least the chance to talk to a consultant as I don’t even have a name. I got the feeling that I was going to be discharged if I hadn’t mentioned my gps concerns. It feels like the gp and hospital are having a battle to see who is going to take responsibility of me. I thought I would gather questions for the review of the results and hopefully get a plan formulated.

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All I can offer is that Arrhythmia Nurse Specialists are usually highly trained individuals and often more au fait with AF than normal cardiology registrars. A lot of hospitals run nurse led clinics for new AF.

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You may well be right bob my only concern is that he would have made a good politician by avoiding the questions!

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I don't understand if your GP thought you'd had a heart attack why he/she didn't send you straight to A&E ? Mine even offered to phone an ambulance

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Sorry mike i didn’t clarify in post as I had mentioned this in a previous post, this was a historical event that showed up on an ecg. However I had been in hospital with AF and it had not shown up on their ecgs. I did have slightly raised level of troponin but when another dr saw the level she said that my level was tiny.

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Ah that sounds like they are proceeding correctly then. Troponin levels can be raised slightly simply by an AF attack. And having had one, trust me you don't want an angiogram unless absolutely necessary - it's far worse than an ablation.

If the 3 day monitor shows any issues a better next step is a cardiac MRI to determine the state of the blood vessels, after which they would decide if stenting is needed, or even a bypass. These are more powerful than normal MRIs and weren't available when I had my angiogram.

But the fact you saw a nurse indicates they expect neither to be the case so I'd carry on educating yourself on the possibilities so you can ask the right questions.

What was your troponin level, and which type of trop test was it, and how many hours after the event was it taken ? I had some junior medics on a ward round diagnose me with unstable angina from the level and I told them that was nonsense and to go and ask the cardiologist. He actually came and had no hesitation in saying I was correct, causing six red faces.

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Hi mike I am not sure what my level is I have diabetic nurse on Friday so I will ask her to look at my records for troponin level. You have just reminded me that the nurse did mention the possibility of a cardiac mri or angiogram

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ok that's good - sounds like you're in reasonably good medical hands, but with poor communication abilities. Better that way than the other way round :-)

I'd get printouts of all blood tests and keep them with your prescription list so if you have to rush into hospital they know what the base line normal is.

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Thank you for your advice. I have a file that I have all my medical communication etc. So I will ask for a print out from the go to keep with all my other results.

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