After a week of breathlessness and chest pain , yesterday I spent the day in A and EThey gave me an ECG , blood test and xray and diagnosed heart failure , extremely scarey
I am a bit shocked as I have seen my cardiologist regularly for Afib.
Four months ago I had a ultrasound exam of my heart to test the blood flow and everything was fine
Can heart failure come on quickly ?
I have been told to continue on Xaralto and Flecainide ( thought this had to be stopped if there was any concern about blood flow )
Lasilix and Diffu -k 600mg ( which sounds like a very heavy drug to me )
Asking you once again for your help and comments please
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Summerlily
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Sadly I can't offer you any real help or constructive advice .... just sympathy. I have been going through the breathlessness bit for some months now, very slowly getting worse. That said, I've not had the chest pain. Mine is also accompanied by a phlegm type cough. I too have seen my Cardiac Consultant regularly this year since April, my next appointment will be around next April/May 2025.
In fact my breathlessness can come on even if I'm sitting watching TV - not necessarily if I'm out walking/ exercising. Next week I have to attend for a chest X-Ray on Thursday and range of Cardiac Blood Tests on Friday. I have had two Echocardiograms, two years apart. October 2020 showed a Ejection Fraction of 68%. The next Echocardiogram was November 2022 - showing and EF of 65.2%. As there are no further changes to aortic or ventricular dimensions they are not going to do another Echocardiogram this year.
My medication is currently, Sotalol, Warfarin, Simvastatin and Felodopine. Some success though, I've come off Ramipril, in an attempt to address my coughing that I mentioned. I have had tests to make sure if I need to I can take Flecainide - but - so far, my Cardio guy doesn't want to go there yet - rather keep it as spare ammunition.
The only other good thing is that I've been able to control my blood pressure ....... Oct 2020 it was averaging 152/87. November 2022 was 142/72 and currently it is around 135/80 with a HR of 76
Certainly are of interest and sympathy is always appreciated Hope your tests next week reveal something helpful and you can get rid of the breathlessness
New Zealand has called a WARNING of Whooping Cough Epidemic. All babies and those over 65 should vaccinated. 263 to date hospitalised with ? passing. Recent.
Could yours both be whooping cough which is not a virus but bacterial. It needs an antibiotic for sure. If you have phlegm then pot it for testing. I did for suppositively flu and it had a virus strain and pneumonia a baterial strain. Amoxil got me better in 3 days on a 5 day course strictly 8 hrly.
Heart pain oh dear awful sensation I can imagine. Medical needs to separate heart pain and stomach pain. My Mum was given a tummy settler!
It depends on how that is being defined. My permanent AF has been described as heart failure and first degree heart block. Did A&E do a troponin test (for heart damage) bearing in mind that the threshold for women is lower than men? The usual procedure is to do a troponin test on admission and again before discharge. Did they do a 5 or 12 lead ECG, and if so, what did the electrophysiologist say? You probably need to ask some questions; I assume that your GP has received a report.
Your cardiologist is your expert so I would check things out with him. I once went to a and e and they took me off my cardiac meds. I was so poorly after their removal. My cardiologist was furious and told me never to let an a and e doctor change them and to ensure if in a and e again then he is to be contacted for his specialist advice.
Giving a big diagnosis without that specialist input doesnt seem quite good enough. Best wishes and hope your consultant can fully diagnose your actual cardiac status.
Sometimes in A & E do take you off meds so they can assess you without meds hindering and putting back the necessary ones.
When I was helicopted to our base hospital I was on no meds. But offering me Metoprolol when I said "NO it will make me breathless" was ignored by the Endocrinologist.
With Stroke embolic, rapid & persistent AF and then on day 4 during a carotid scan a shadow was discovered on my thyroid. Carotids were clear. But it was carcinoma on the edge of my thyroid lobe right. Later bits in left lobe. Actual Thyroidectomy included 12 lymph nodes (2 infected).
***They should have tried me on a BB or a CCB until heart rate was under control. They didn't.
So from Sept 2019 - December 2021 to try out CCB left me with H.R of 186 and 156 on change,... to Bisoprolol.
CCB Calcium Channel Blocker Diltiazem 1/2 dose 180mg took me from 156 on Bisoprolol 10mg to 5mg to 51 in 2 hours.
Now on AM Diltiazem 120mg control H/R to 60s Day climbing to 89 late afternoon but my normal H./R avg 47bpm NIGHT.
PM (must be separated) Bisoprolol 1.25 (just reduced from 2.5mg) control BP 120-134 / 69 -79.
As Diltiazem which is a safer anti-arrhymic med than Flec works on both H/Rate and BP.
But if have venticle or valve abnormality, you need a different CCB like Ver....
I have a severely dilated left atrium. So no cardioversion, ablation, anti-arrhymic med.
Hi there - try not to worry, I have had this problem. In 2014 I was hospitalised with heart failure and AF. I had severe fluid retention which caused swelling of feet, legs, abdomen, stomach and fluid on the lungs. I was in hospital for 2 weeks before all was under control. My AF has become permant over the years and the HF has been under control.
There have been a few ups and downs, stays in hospital mainly with viral chest infections. Last November I was in hospital with breathing diffculties and high heart rate, this again was put down to a viral infection but on my discharge letter it stated that I had chronic HF and chronic COPD. I did not notice this until I had returned home, on the bottom of the letter it said they had referred me to HF clinic and COPD nurse at my surgery and they would contact me. I do not have chronic COPD , I do have asthma and mild COPD. The surgery nurse rang me very concerned and started asking me how I got on with the oxygen and was I able to move around okay. I am not on oxygen never have been and I am quite mobile, goodness knows what they had put in the letter to her. Outcome she did not need to see me. Same with HF team, asked loads of questions ect and said everything seemed fine and under control no need to see them (I had been under their care from 2014 to about 2018 but discharged as I was keeping it under control). The A & E consultant had taken me off Ramipril because it gave me a cough. I did not tell him this, he asked if it did I said no maybe at odd times. I have tried some of the other pril meds but Ramipril suits me and I am told is good for my HF and it helps the heart pump stronger. I refused to stop Ramipril and eventually one of the ward doctors agreed, if I was happy with it and had been on it for 10 years, so it was put back on again.
If A E had been that concerned about your HF surely they would have had someome come down from cardiology to see you while you were in A & E. Do you have any fluid retention it is a main sign of HF. Your echo results are good and you are being seen regularly so I would not worry too much, I am sure your cardiologist will be able to tell you what is going on. I have never had any real chest pains so I cannot comment on that. The last drug you mentioned I have never heard of what is it for. Do you have any other health problems. My medications are Diltiazem, Nebivolol, Ramipril and Xarelto and flurosemide (water tablet, I only take when any sign of fluid retention which is not often). Also I have two inhalers for asthma and copd plus a few others for other ailments. Hope you get this sorted but I am sure you will be okay.
Hi - I agree I wish they would not use that term it sounds so final as if you have not long to go. Medications can keep it under conrol, it is purely the heart is not functioning at is best. I am still here after ten years nearly 11 now. As someone else said A & E doctors should not change any heart medicine without consulting your cardiologist or the cardiology department. The one that took me off Ramipril did not replace it with anything else, that would not have been good for me. You could have some fluid in your lungs that will cause severe breathlessness, but that can easily be sorted. Because I have HF and asthma it is sometimes difficult to know which of the culprits that are causing the breathlessness. Take care you will get sorted and if you do go to A & E again, stand up for your self, many young A & E young doctors know little about AF, just take the text book approach , AF & HF differ in many people. Have a good rest of the weekend.
We panicked when my husband was diagnosed wirh heart failure but found the BHF site most helpful for sensible, easy to understand information about the different types and stages of heart failure. It put our minds to rest to read that people can luve for years with heart failure. It always sounds like a death sentence, but it isn't. It just means your heart is not working efficiently. The HF nurses hate the term 'heart failure' and I believe most medics are trying to get the term changed.Hope all goes well for you when you finally get to discuss it with your doc, but meanwhile, do check out British Heart Foundation info.
Any sign of ankle swelling ( I do on long hot drives) I raise my feet on pillows at night. It is away in a day or two. I am on Diltiazem too such a marvellous med but care on dosage at introduction.
yes, I have HF too, take loads of medication, rivaroxoban, flecainide, Bisoprolol, candesartan, Atorvastatin, bumetanide, dapagliflozin! Permanently swollen legs and feet! Not pleasant at all, I have a heart review with GP this week!
Yes,, mine came out of the blue about a year after a fall and consequent hip replacement. I have been medicated with Bisoporal and diuretics now for over a year and have to admit it does have its limitations but still can lead a good life. The diagnosis is scary I know but people live years with HF
The heart is a pump. If the pump has a bit of a problem it still pumps. That is how my husband views his heart failure. The "failure" word is very misleading because the heart will continue to pump but just be a bit slower than a healthy heart.
please try not to panic even if it is heart failure. As has been said it’s an awful term heart insufficiency is better. Mine did seem to come out of nowhere in February this year. After ten years of AF and having drugs, cardioversions, ablations and finally Pace and Ablate I was doing reasonably well. Then in February I was taken ill on holiday abroad with very low electrolytes Magnesium and Potassium and pneumonia. It was while I was in hospital they gave me a Pro BNPblood test. As I understand this is the main test for heart failure. My result was very high and I was told it was heart failure. Most of my meds have been changed and I am on Entresto amongst others which I understand is really good. I’ve just had another Pro BNP blood test and I have improved quite a lot. I totally understand your panic I’ve been very up and down mentally but it’s treatable and BHF has good info and I’ve found a charity called Pumping Marvellous Foundation is very supportive.
Hi, sorrow to hear. I had a scan last year and was told everything was ok, but a scan in Sept and they now say heart failure. Same as you I don't understand how, why. I've had no symptoms or breathlessness and now have an appointment to see a consultant.
I was diagnosed with heart failure, following about six months of constant tachycardia following an ablation gone seriously wrong. That’s a whole other story. Our hearts can only take so much wear and tear but the good news is it’s reversible also. Did they tell you your ejection rate? I have been on Xarelto and have been told I will be on at the rest of my life. Never has it been stopped except for one or two days for surgery and the last time they do that. I was not stopped any of my meds. I am not familiar with the other two you mentioned. I had lost the ability to walk because of blood flow. I could scuffle to the bathroom around the corner from my bed, even that was hard and the pain in my chest instantly brought tears.
Fast forward to my new doctor. He cut right to the chase. He is not a big fan of ablations. because it is so hard to get the right spot he wants quality of life ASAP for us not just making money for the hospital. He wasn’t always their favorite child because of this I have seen people on this site a dozen or more ablations I don’t understand that. I only had three and I was so badly scarred. There was not even consider consideration of another one except for the AV node. Yes I got a pacemaker about a month following the diagnosis of heart failure. He said my heart just cannot take anymore. Neither can I. It was the best thing ever done. When I left the hospital, I was able to get up out of the wheelchair and get into the car by myself prior to that as I said, all I could do was scuffle to my bathroom in tears from pain. I won’t tell you a pacemaker is perfect. There is a learning curve between you the pacemaker and your body but with the right doctor, they should be right there for you and if something makes you nervous call and ask. knowledge is power when it comes to something in your own body don’t worry about everything else. Don’t worry about numbers if you. That was one of the first things he made me stop doing because our numbers are all over the has that happen depending on activity so you will make yourself crazy. I also did not realize after the surgery that I would still be able to feel my a fib and flutter I was scared so I called my doctor and saw him. He explained to me yes you will be able to it. You can still trigger it with certain things however it no longer can do harm to your heart. The pacemaker becomes the boss and you I have triggered it with ice cream or a very cold drink or over eating because dinner was too good Eventually, you will figure it out. In the meantime you might be uncomfortable, but you’re gonna be OK.
the best news it’s been about a year and a half now for with the pacemaker at my one year extraction rate went from 40 to 7 in the 70s is good even for someone my age, which is also 72 even without a pacemaker. Yes my heart had a chance to rest. It’s doing great my serious humble doctor even smiles and gets excited. On top of everything else he had to make a pacemaker for me with what existed because there was nothing specifically for my problems I’m quite a mess in there all four chambers. I even have an extra lead, not connected right now, but if it is needed, it’s ready.
this is just in case they a pacemaker with you when they figure out what’s really going on and how you changed like that believe it or not mine was also anxiety. It was what kept setting off my a fib. I thought my doctor was crazy, but he could see what I couldn’t. I had medication it said take as needed. He called my primary and also told me you need a lot more than you think. Obviously he was right. I still get tired. That might be my age which I still deny lol I am 35 in my head, not 72.
keep your mind open. They are making new things every day for there’s no cure for a fib but when other things happen like the heart failure, they have good solutions now. I am known as unique at the even with the maker of my pacemaker. I have a tech assigned to who has been with from the day of the surgery, she always at my check ups. When I was having issues last summer, she was with my doctor and his assistant, and they had an engineer from Medtronic online. I have an app and they can take readings anytime they want. I have one coming up December 2. I am also monitored 24 seven from the same app and if it picks anything up, my doctor will know before I do.
heart problems are life-changing, but you can either stay down and die or deal with it and find out it’s not that hard to deal with. The only time it was the most difficult for me was after the bad doctor. I waited six months to go elsewhere while being ignored by the that did the bad surgery. That’s probably why I ended up with heart failure.
my doctor has left me but for a good reason so I can’t be selfish. He was given a job at a major university hospital in chief. I don’t even know if he is 40 he is young humble and deserves everything good. He was not concerned about leaving according to him just like a I should only need maintenance like a battery change eventually. I could tell he was being honest this man does not tell lies
let us know how you are doing and what they are doing for you. Do what you are told they spent a lot of time in school learning to save us. On top of being a doctor and a cardiologist and EP is also an IT specialist they get the degree. My doctor said learning never ends. He has more letters after his name than the alphabet has. I am so proud and so blessed to have had him for my doctor. Best of luck.
Wow Dawn , that is a story and a half !Brilliant you have come through it all in such a positive way
After all the brilliant knowledgeable and reassuring posts on here I feel much more confident
Will know much more after my rdv with my cardiologist on Fridsy .A and E didn't explain much as they were so busy but the meds they gave me have certainly helped with the breathlessness and chest pain
One doctor said to me that Heart Failure is a bad description. Heart insufficiency is what they call it in France - not so scary.You ask can it start suddenly? In my case yes. I started to have trouble going up slopes. I had an echocardiogram it showed Ejection Fraction (EF) of 30%. An echo 6 months before had been normal. I was stunned to be told it was HF. In fact I cried.
In my case it was pacemaker dissynchrony and new pacemaker with an extra lead has brought the EF back to 60%. I've also been given Dapagliflozin and Spironolactone. Was already on Lisinopril and Bisoprolol and Apixaban. Entresto is another appropriate drug but I haven't been given it yet.
One thing you mentioned is Flecainide. My Electrophysiologist was adamant I stop Flecainide, although the HF consultant said that was overcautious as it's important to keep AF at bay. Anyway I'm off it for now.
I hope you come to terms with HF. It's not a death sentence but it's a hell of a shock to be told you have it. Good luck and keep positive.
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