When to go to A&E and when to sit it ... - British Heart Fou...

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When to go to A&E and when to sit it out.


I was diagnosed with AF last July - I take a Beta Blocker a Blood thinner and a BP medication. I am constantly aware of my heart as I have Tinnitus which means I can hear it pulsing away day and night.

Since my diagnosis I havnt seen a consultant - I had an echo cardiogram done and was told no further action was needed, to take the medication as prescribed and attend for my blood tests when called. The only help and support I have found is on this site - and I am so very grateful.

I need help again - I have been feeling breathless on occasions just lately, and it is concerning me - add this to the constant tiredness and lethargy, weight gain and mental turmoil, and you have the complete mess that is me.

Last night - after not doing anything out of the ordinary my heart started to do the Rumba, and I panicked - trying to take control of the situation I took my blood pressure which was 151/79 and a heart rate of 51 - nothing really untoward i think - so why was my chest feeling the way it was?

To call an ambulance or not to call an ambulance - my heart wasn't racing, but was palpitating obviously - what do I do in this situation. As it was I sat it out - i carried on stopping and then starting again for the next 3 or 4 hours finally stopping altogether early morning. What was this - was it an AF episode, was it just palpitations with no strings or something else - I am so confused and worried to death it may start again =, only worse next time.

Any information please - many Thanks.

Barbara x

30 Replies

Hi Barbara, If the breathless and tiredness are new or have worsened, you should go back to your GP and ask to be referred back to the cardiologist. If you are getting irregular heart beats and palpitations it could be that you may need a pacemaker but only the cardiologist can do further tests and make this decision so do go back to your GP before it happens again and ask to be referred back to the cardiologist.

in reply to angedogs

Thank you - I am there on Thursday so I will do.xx

in reply to Brummiegal

If it happens again while you are waiting for your appointment and you are worried about going to A&A you can call 111 at any time and they will advise. Good luck.

Hi Barbara having had af since 2014 I know how horrible it is.when first diagnosed given a couple of meds and sent on my way blah blah had a echo showed heart working at 20% worst year of my life.i tell everyone this it's your life and you want the best for you af is the devil's curse to the heart world.ask about a cardio version or abalation are you on warfarin also bishop and amiodrone that one is for af so they tell me.regardin a&e on my many trips there they told me sooner deal with a false alarm than people ignoring heart discomfort.good luck with the af and take life at a slower pace until they get you right.

in reply to golfgod

H golfgod,

Thank you for responding - you are so right about this illness, there seems no rhyme nor reason to it - no list of things to do to get and keep this under control, no real plan of action - the advice from my GPs ( I say that because you never see the same one twice) is vague and useless and of no comfort whatsoever when I'm sat in the middle of the night with my Heart doing Somersaults, not knowing what to do for the best - It's not an illness that seems to get better, it just changes all of the time - One day my hearts beating too fast - I get palpitations - I take a Beta blocker and now my heart is beating so slow sometimes I fear it will stop, and I still get palpitations - I have no energy, I am tired ALL of the time, I can fall asleep while talking on the phone - it all terrifies me - I don't know what to do for the best - I'm drowning here.x

Barbara x

in reply to Brummiegal

Hi Barbara try not to panic easier said than done I know.i have a Samsung phone got a app called samsung health I love it bpm stress oxygen sleep patterns.at it's worst I was out of breath having a bath wife had to get me out every time.mine was constant I now have a icd fitted I'm at 33% paceing my heart try and not let it rule your head if bad 999 like I said they would rather attend a false alarm than the worst case.keep pushing gp and cardiologists.more you push the faster you get sorted I know did not except it at ist but now I push big time.always here if you want a rant or chat if you ain't had it you can not understand it

in reply to golfgod

Your a saint - finding someone who understands the panic - I try so hard to talk myself down out of it, but it's not easy - especially in the early hours of the morning.

The only time I have seen a Cardiologist was when I was being discharged from hospital after my rush to A&E and a night of observation, he told me what meds he was going to give me and why, said we will meet up after your echo and decide what will happen with your future treatment - I havn't seen anyone since - my echo report came to my Drs surgery saying all was fine and no further action was required - my GP said it appears youre one of the lucky ones - I dont feel lucky I can tell you - I feel isolated and uninformed about what is wrong with me.

I'm heading off to the GP's tomorrow and I have a list of questions that he probably doesn't know the answer too, but I will ask them anyway. I want my diagnosis of AF confirmed or further investigation. Do you think it reasonable to ask for a Holter Monitor because If I go and say I'm worried about whats going on with my heart rhythm he will give me an ECG which will just show what's happening at that time - I want it monitored when I'm trying to get to the shops and have to keep stopping to catch my breath, or when it decides to do the Rumba at 10 o'clock in the evening or 3am in the morning and when at rest sometimes it beats so slow I panic that it will surely stop - that's when I want it monitored - then I want a referral to a Cardiologist to read these results and tell me whats wrong - if the Echo says all is fine why is my heart going beserk on occasions and frightening the life out of me - answers - I must have them. When I know what I'm dealing with, then I can deal with it, whatever it turns out to be - but this uncertainty is driving me insane

Thank you so much for listening - as I said, Your a Saint.

Babs x


If you phone 111 or see an emergency gp with a heart problem they will more than likely suggest you visit a&e. Your own gp will have more of an idea of which direction to send you. I think we’ve probably all had an episode which has made us want to reach for the phone.

Its important to get it investigated by your gp.

I was unsure before and rang 111 instead of 999

Hello Brummiegal

One thing about going to A&E is they can monitor you when you are having an " Episode "

do an instant ECG which would be helpful in your diagnosis .

regards Frank W

Meant to add

I believe that Paramedic or Technician can also do the necessary Tests and decide if Hospitalisation is required in certain cases. They will also then have the information for your diagnosis !!!

If,your heart rate was,actually 151/79, and not a type-o....that’s Way out of normal! Also, HR 51 IS bradycardia!

Hi there, thank you for responding. My Blood Pressure was 151/79 which I thought wasn't too bad - I am very worried about the low HR and have mentioned it on every visit to my GP but they don't seem bothered about it and then I feel foolish to have mentioned it.

I have a GP appointment tomorrow so I am going to bring it up again .

To be totally hones SpiffyHeart I am totally lost and confused - I feel as I have been given my bag of medication and dismissed, every time I bring up a concern it is made light of.

Barbara x

Hi Brummiegal. I have AF and HF. If you are ever worried go to A&E. Not to frighten you but it was AF that caused my heart attack as the pace slowed so much the blood pooled and clotted. My daughter in law is a GP and goes mad with me if I don't go to A&E. She says that the best time to be seen is whn you are having the symptoms so they can really see what is going on. That's what they're there for - not the broken fingernails and lost paracetomol

It might be the time you take your beta blockers that's causing your tiredness. I started off taking mine in the morning as originally advised but I felt wiped out all day. Once I started taking it in the evening the tiredness became more manageable.. I just go to bed earlier.

If you take it in the morning it might be something to talk to your GP about.

Hello Marc68 - many thanks for your response - several people have mentioned to me about changing the time I take my Beta Blocker, it sounds as if it is definitely something I need to talk to the GP about, I have an appointment tomorrow so I shall add it to my list - he's going to hate me - but I need answers I can't carry on like this.

All the best


in reply to Brummiegal

Hi Barbara, no problem. Changing the time taking BB's made a world of difference to me so it could be something to consider. Not sure it will help with your AF or not as I don't have it.

With regards to the GP's; you have to take control of your own health issues because they generally don't any longer... If you want a holter monitor, ask for one. If they don't have the answers to your questions, ask for a referral to a cardiologist. You need to push most GP's and sadly quite a few of them don't seem to have much understanding of heart disease or treatment. Some do, some don't.. it's pure luck which you get I'm afraid.

As you say, once you know what you're dealing with you can start to come to terms with it so keep asking until you're satisfied you know what you need to know. Unfortunately the turmoil you are going through is something we all go through.. the good news is that it does get easier, I promise, it just takes time.

Take care.


in reply to Marc68

Hello again Marc,

Just thought I would post an update on what has been happening to me of late.

I did contact the Drs surgery the morning after that results telephone call from reception - i was told that unless I was prepared to take 'Pot Luck' on the Dr stakes I would have to wait 2 weeks before I could see the Dr who had ordered the tests and was supposed to be organising my Heart Monitor.

I decided to take 'Pot Luck' and got an appointment to see the 'Newbie' Dr - well thank goodness I did - he was marvellous.

I explained why I was there ( really difficult trying to bring someone up to date with proceedings when you know you're against the clock). he listened, read my notes off the screen - checked my HR and said I was in Sinus mode, which is great, but i already knew that - said the ECG taken showed I was also in Sinus mode - I knew that would be so too, and at this point I was expecting the 'Fob Off', but instead he started to ask me a load of questions about how my heart felt when I got the Palpitations, did it affect my breathing had I any pain etc etc - and then said ' to get to the bottom of this we need to get that Referral to a Consultant sorted asap and from there the recommendation of a 24 hr Heart Monitor - I could have kissed him.

I watched him raise the letter to the Heart Clinic, and then asked him if it would be ok for me to take my Beta Blocker at night instead of in the morning, as fellow sufferers on here had found some relief to the tiredness, he said fine.

That was over a week ago, and I can't tell you how much better I feel, I have energy again, I'm not falling asleep during the day - I'm not up to running up the Great Orme yet, but I am getting out and walking plenty, doing my housework and gardening and going shopping - wonderful, who would have thought changing the time you take your medication could make such a difference.

Anyway now I am waiting for that hospital appointment and to see a Cardiologist at last, and hopefully answers to my questions.

All the best,


in reply to Brummiegal

Hi Barbara,

That's great to hear you found relief from the tiredness. I felt the same when I changed the time taking the BB's. The difference was like night and day.

It also sounds like you've found a good GP so if I were you I'd try and plan forwards with future appointments and see the same one, even if the appointments might take a bit longer.

I'm very happy to see you're making progress. Every little helps.

All the best,


Emily_BHFBHF Nurse

Hi Barbara,

I am sorry to hear that you have been going through this difficult time. Firstly, please make an appointment to discuss this with your GP. It would be worth seeing if you would benefit from additional tests (such as a 24 hour tape) in case you have any additional episodes like this and an echo scan. There is more information about these tests on our website.

Although people can have a good quality of life with AF on medication alone, sometimes people have treatment options including cardioversion and ablation which would be worth discussing with your doctor. These treatments aim to revert your heart rhythm back to sinus rhythm.

If you experience these symptoms again, I would recommend calling 999 if you are concerned or if you are unsure, call NHS 111 for urgent medical concerns.

Tale care,


Hi Barabara, I don't suffer from AF but had a small heart attack last January and am on medication. I do get palpitations however, but whenever I have mentioned it to any health professionals they have not been overly concerned. I have been told if they get particularly troublesome to tell them and they may consider beta blockers. The palpitations come and go, and yes I also get the galloping heart at night (seemingly for no reason), and can't sleep easily if I can hear my heartbeat. Of course it's also worrying and goes round in circles causing anxiety.

I have found things improve a little if I get out for regular brisk walks and elevate my heart rate a little. I also use a couple of remedies from Traditional Chinese medicine that sometimes work. One is to use a pressure point on the wrist - on the centre of the inner arm, three fingers widths below the crease of the wrist, You press this point with the thumb and hold for 30 -60 seconds, or you can press on your outward breath, release on the inward breath, three times. Another is a hand position or 'Mudra' which is also related to the Yogic tradition. You place your index finger to the base of your thumb, touch the middle two fingers to the tip of your thumb and straighten the little finger. You can hold this position for a while. I often find this stops the palpitations very quickly, but not always. I have showed this to others who found it useful - and it is harmless and has no side effects. Repeat either of these methods whenever you wish - I often sit on a car journey (not driving!) or while watching TV holding the hand position for a long time - I feel that the effects are cumulative and the more you do it, the more effective it is.

Finally, I told my mother about the palpitations and she told me my Granny had them all her life - and she lived into her 90s, which I find VERY reassuring. I hope my post helps you, good luck!

Hi Lesley - Thank you for your response, I really appreciate your suggestions and comments.

In an effort to bring all of this stress to an end i attended an appointment at my GP's - I poured out everything - asked him for the Heart Monitor for 24 hrs and a referral to a Heart Consultant - to clarify what is wrong with me and why I am suffering with all of these symptoms.

He listened - read my notes from the hospital then gave me a general once over - he said we had to follow a procedure - up to date tests first then we will sort out the monitor and then on to the Hospital. I had blood tests done as recently as November but he said they wern't current enough.

So yesterday I went and had my bloods taken and then on to have an ECG.

I was told I would need to make an appt to see him again once the results were through.

I had a phone call from surgery this afternoon whereupon the receptionist told me my results were back and Dr was pleased with 5 of them - and to make an appointment in about a month - WHAT? - has everything I said and the promise of the monitor and a Consultation at the Heart Clinic just been brushed away - I am so angry and stressed out I could cry. So I will ring in the morning and get an appointment - I need to know what is going on, do they not realise the stress they cause people - or is it that they just dont care.

I will post what happens.

Babs xx

in reply to Brummiegal

Hi Babs,

Are you from Birmingham, I am guessing so from your name Brummiegal. I am from Birmingham.

Just wanted to know how you have got on.

I worry like you, when to go and when not too. Each time I have rang 111 they have wanted to send an ambulance but I have refused and got my hubby to take me to a&e.

Hope you are getting answers x

Hello Barbara

Positives are your ECG must look OK or they would of told you immediately if your not in Sinus Rhythm, says he who is an Engineer not a Doctor.

Yes I agree when you get your results via a telephone call it's not the best way to get information on your medical condition. But it doesn't appear anything is wrong or your GP would have called.

Holter monitors are read by a computer ( I Believe ) and just give a print out of the recordings for a Cardiologist or a Technician to look over. Medication seems to be pretty standard Beta Blockers, BP Medication, Statin or Aspirin.

I think we all worry a little about HR mine can swing from 80 to 30 BP, average is around 55 and my Cardiologist thought 55 a little high so increased Beta Blockers.

We are all different in size, shape, lifestyle are all these influences our BP and HR

So please try to relax if they/them think you are at risk they will act. They Them do have your best interest at Heart ( not a pun )

Best Regards Frank W


If you are in the uk I would ring 111 for advise they will send an ambulance if they think you should be seen. That way you haven't had to make the decision.

Hi Brummiegal, sounds like trouble i had, they kept changing my medication for my BP, as mine goes 200/ 100 iam so frightened when it does this , tried lots of medication that did not suit, was rushed into hospital so many times, if you have gone on new medication in the last few months, read the label that comes with the tabs, i was taking one and i could hardly get my breath, when i read it the tablets was the cause, dont suit everyone, so had to come off them two weeks later my breathing was back to normal. Hope you get on okay.........xxxx.

Hello Barbara. It could just be a panic attack through thinking about your condition too much. It’s surprising what being over concerned with our various conditions can do to our heart rate and indeed palpatitions. You will know when a fib strikes you can’t feel your pulse it’s so fast. Just like one long beat. Calm down and rest. Mike

I wonder if you live on your own? I know that whenever I start to panic about my heart failure symptoms my husband sits me down and talks reason. I do the same for him. I imagine it would be harder on my own but this forum must help.

Hi, I hope your doing well. If your put on ivabradine I was told your heart rate shouldn't go below seventy so dosage may need adjusting. Xx

hi regards palpitations, HR and BP.. last year i had been feeling pretty grotty for a few days.. one night was feeling really strange.. tookmy BPwas 179/90.. HR was fluctuating between 48 and 51.. phoned 111 who immediately sent an ambulance.. paramedic took ecg, bp said a lot of thigs were going on plus resps were 28.. spent overnight in hospital on a monitor.. doc in the morning said HR overnight was struggling to get into the low 50’s.. result was halfing ivabradine dose and taking me off spirilactone.. maybe your meds need readjusted?

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