Cardiology appointment : Hi I have an... - AF Association

AF Association

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Cardiology appointment

Maclan
Maclan

Hi

I have an appointment to see a cardiologist tomorrow and it's been a long wait as my stroke in April 2017 was caused by AF and this is the first time my GP has referred me. I have been having tachycardia and breathless episodes recently and been on betablockers for 6 weeks that have just made me very tired. How do I make the most out of this referral what questions should I ask and what should I expect ? It seems so important and I want to get the best advice.

12 Replies
Hidden
Hidden

Not an easy question for to answer Maclan, but some of us enjoy a challenge. Going to make some assumptions:

Hopefully you have recovered well from your stroke and apart from the issues you mention, you are reasonable well. That you have had an echocardiogram so you are aware of the general condition of your heart. You are taking an anticoagulant, ie warfarin or a DOAC. Although you would be better seeing an Electrophysiologist (EP), the chances are your appointment is with a Cardiologist.

It would be helpful to have a log of how your condition has evolved since diagnosis together with some notes about how you have responded to your medication. You haven’t given yourself much time, but hopefully you are aware of the various treatment options available and perhaps you have some idea as to what you would prefer to do, ie pursue cardioversion and/or ablation therapy or continue with medication therapy.

The consultant will pursue a line of questioning which will cover most of these options, but you need to be clear in your own mind about what you would prefer to do so that he can assess if, in his view, what is right for you. If you have not had the usual tests which determine the overall condition of your heart, called an Echo (Echocardiogram) then push hard for one.

Hopefully others will come up with other ideas and suggestions.....best of luck for tomorrow, please let us know how you get on.

Maclan
Maclan in reply to Hidden

Thank you Flapjack. Sorry I didnt give very much information. I was lucky I was in the GP surgery during my stroke and was blue lighted into hospital so only have a few problems inc right sided weakness although I do have memory issues. I panicked because this appointment is so important to me hence the post because I am worried about my heart condition and want to get the right treatment but the post stroke support hasnt really materialised probably because I have recovered well and I don't need as much aftercare as some but I dont know anyone else who has been through this either so I read healthunlocked all of the time hoping that I can find useful advice. I am on Apixaban 5mg Amlodipine 10mg Atorvastation 40 mg Lisinopril 5mg Lansoprazole 30mg and Bisoprolol 1.25mg and I have had an echocardiogram a seven day heart monitor that showed an enlarged right ventricle and AF I really want to know if they can do anything to lower my risk of another stroke and improve the health of my heart. And I hate being on the Bisoprolol because I am so exhausted since Ive been on them.

Hidden
Hidden in reply to Maclan

Thanks for the info....many here have issues with Bisoprolol and they have talked favourably about Nebivolol so that may be worth pursuing. It sounds as though you already have a good few things to cover tomorrow, but please jot them down otherwise you may not cover everything and if possible, take someone with you just in case you don't remember all the answers......you will be fine...….

Maclan
Maclan in reply to Hidden

Yes my list of questions is a long one already. Thanks for your time and advice.

Hi Maclan - As Flapjack suggests, you’ve given little information for us to offer advice. Presumably you want to feel better but is it the symptoms of the AF or the side effects of the meds that give you the greater problem? You should confirm the diagnosis with the cardiologist. Do you have any other cardiomyopathy? If not, or if the cardiologist feels that othe issues have been caused by arrhythmia, then you probably should seek referral to an electrophysiologist who specialises in the electrical function of the heart: rate and rhythm. You probably want to know what treatments would be considered appropriate for you and the risks, benefits and probability of success for each.

I hope this helps. Good luck and let us know how you get on.

Hidden
Hidden

I would ask about a CT carotid angiogram, an increased dose of atorvastatin and possible antiplatelet agent. With a 67% carotid stenosis last year, these are all considerations in preventing further stroke.

In the matter of your heart, you might want to ask why your left (not right?) ventricle is enlarged and what can be done about that.

Perhaps ask someone to go with you as there will be a lot to remember.

Maclan
Maclan in reply to Hidden

That should have read enlarged left ventricle, narrowing of right atrium. I should have checked that before I posted. Sorry

Hidden
Hidden in reply to Maclan

And I should have rechecked your intro 🙂. Clearly a right sided stenosis would not have caused a right sided stroke. Nonetheless at the very least a repeat carotid ultrasound seems justified if you are concerned about a further stroke, albeit of non cardiac origin.

I quite understand, I've been there. Firstly any medication beta blocker or blood thinner can change how you feel. You have to give it time to settle down. Nevertheless You should ask the cardiologist about the effects of the drugs you now take. Don't expect him to know - most specialists are seeing your file for the first time and are only cursorily aware of you medical history. So plan your questions and don't be afraid even to have a written list with you. Once you're out you can't go back and ask. Good luck

Maclan
Maclan in reply to sandflopper

Thank you my appointment is at 3pm and I don't know how much time I will have so the list is ready.

IanMK
IanMK in reply to Maclan

Perhaps a bit late now, but - as Oyster says - having a companion with you will help you to remember more of the replies. Any teacher will tell you that pupils don't take everything in at the first attempt.

Maclan
Maclan in reply to IanMK

Very true but despite my post stroke memory issues I didn't do too badly on my own. I took notes and a list of questions. I currently care for the person who would normally accompany me as he has been very ill and my closest family are 5 hours away. The cardiologist Dr Lelioudis has changed my beta blockers to Sotorol and I will see him again in 3 months. If they do not resolve my symptoms he will arrange an ablation. Thanks everyone for your advice.

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