British Heart Foundation
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Confused about discharge notes

Hello,

It's my first time posting here so thank you in advance for any help anyone can give.

My dad was admitted to hospital just over a week ago with symptoms of breathlessness, tight chest and feeling faint after very little exersion. He has had symptoms off and on for a while now and GP had previously carried out 2 ECGs which showed a resting heart rate of 140bpm, prior to going to A&E he was on a wait list for a hospital appointment.

After several days of tests in hospital he has been sent home with meds to control the heart rate and is to await a further appointment in 6 weeks. The consuktant has told him he has an atrial flutter, Other than this we have been given very little information.

Looking at the discharge papers they note 'Bi ventricular failure with severe LVSD' and 'Atrial flutter 2:1' can anyone shed any light on this diagnosis in simple terms, I know it', not a good diagnosis but I've googled and have been bamboozled with information. He really hasn't been told much at all and is now at home getting increasingly worried at not seeing a medical professional for 6 weeks and not really knowing what is going on.

Many thanks!

10 Replies
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Hello there and welcome to the forum. Sorry to say I can't really help with imformative advice on you father's diagnosis.

I can say however, the fact that they have given him an appointment for six weeks time. Means they feel the meds they have sent him home with, will settle his simptons down after a few days to a couple of weeks.

Also with their professional exspireance, they would not concider six weeks to be a long time. Which means they feel his condition is being managed and controlled.

So believe it or not, this is a good thing and very possitive. Your father is now on the radar.

So if between appointment times he feels things aren't quite right evan after a period of time on the medication.

Then all you or he has to do is contact his Gp or his local cardiac unit. He will be on their database of cardiac patients. Therefore they will have his notes come up and be able to advice him on what to do next.

Of course if he is poticually worried at any point.

Like chest pain and breathlessness when at rest. He should emediatly call 999.

If they have given him GTN spray he should use that straight away.

In them meantime, get him to keep a diary. He should right down any simptons he has between now and his appointment.

. Date,

. Time of simptons,

. If he has a blood pressure unit, take readings. 1 in the morning & 1at night. If not get him to take in in his local surgery when he can and keep the reading.

. Sleep patterns, does he suffer from ensomia?

. Diet, what he eats, when he eats it,

. Physical exorcise, what exorcises? & how often?

. Mental exorcise, was he under any kind of presure or stress at the time of uncomfortable simptons.

. Has any other exsiten health issues unrelated to heart, got worse. Or do they worsen at the time he is suffering from the heart and breathing incidents?

Keeping a diary with a colum for each section.

Date, time, simptons, meds taken etc. Can give the health professionals a really good insight to what is going on throughout his daily life and how it effects your father.

Receiving a clear record in black and white capital letters, is a good history to help the professionals with their investigations. Which in the long run can help you dad with a good treatment plan. Therefore a speedy recovery and back to a good quality of life.

You should go into the pharmacy and get some sample tubes. Never a bad idea to take a urine sample to each Gp appointment. They can tell a lot from a sample at the time of him feeling unwell.

I would also advise you or him making an appointment with his Gp or maybe the practice nurse at his surgery. Maybe try and get a double appointment.

Talk to them about how he and you are feeling.letting them know that you feel like you are in the dark and in limbo.

Ask them to explain clearly, exactly what the situation is.

To explain their plan of action.

Explain how this will effect him in the future.

Right, if you have managed to read through all this and understand any of it, well done.

I say well done for given up on doctor google. Hugely inaccurate and out of date.

Try one of the BHF nurses on this forum rather than google. Mon/Fri 9/5 I think.

And don't worry about the lack of replys on here. Can be a little quiet at the weekends, due to us all getting mixed up with family & friends etc.

If you receive no replys later today. I am sure you will be reading something on Monday from one of our friends on here who can advise on your father's diagnosis.

Please try not to worry too much, your father is in good hands.

Sending best wishes and hugs, Jo 😊

4 likes
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Thank you for your time and considered response. The diary is a great idea I will have a chat with him about that, I think it may help medically but also with feeling like he is doing something proactive.

We'e been given several different dates for follow-up by different people on his ward (doctors, nurses and consultants) and differing messages regarding an on going plan by different doctors during his time in hospital. We'e been left feeling entirely confused and unclear about either his prognosis or his on going care. One doctor mentioned a cardioversion in a few weeks but this is in conflict with his discharge diagnosis of biventricular failure. Can this 'failure' be reversed by this procedure I cannot find any medical evidence to suggest this is the case. Or is failure as drastic as the word sounds.

He was nearly given drugs intended for other patients on 2 occasions and offered drugs it then transpired he didn't need after being told by a nurse that he needed to read through a leaflet and make the decision himself if the meds were something he thought would help....surely it's a doctors job to decide on appropriate meds no a patient who's mental thought processes are impaired due to his heart rate. We'e been left with zero confidence on anything we have been told.

Sorry to rant! Thank you for your helpful and pragmatic suggestions

1 like
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" Failure " is a drastic word used a lot in medical terminology

Along with quite a few people on the forum I have Heart Failure which really means a Wonky Heart, not quite working properly. but working enough so I can still enjoy life almost to the full. So work on the basis everything will resolve itself in time.

6 weeks is a fairly swift response so looks like your Father is a priority, and now he is on medication to help with his symptoms I am sure he will be feeling better as time goes on. Don't forget you are only a phone call away from experts in A & E should you feel you need them, and you shouldn't hesitate in calling them.

Regards

Frank W

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That’s a good analogy! The word failure freaks my out ! So a ‘ Wonky Ticker’ is now what I have 💓

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Make that double appointment with the Gp.

If you make it clear that nether of you have confidence in what the future holds. Due to the reseption and treatment that has been received so far.

He/she should really sit down and go through everything with you.

Sometimes some medical professionals are very matter a fact about what is happening to us heart patients. They can sometimes forget that it may be quite daunting for us, as it is happening to us.

They see our heart issues several times a day. For us, it can be our first exspireance of the heart stuff.

I think if we remind them sometimes that we are not medically trained. We are the confussed patient. Then they snap out of it and become very good at given us time along with their exspireance and constructive advice.

So just make it clear to them that you don't know what the heck is going on.

Don't forget the diary. Diaries with time tables of events are also very good if we do land up needing to call for medical advice and sometimes assistance.

ie, first aiders, paramedics, A&E etc.

Try not to make too much of words like heart decease, failure.

We all go on to realise this can be miss interpreted. It isn't the doom and gloom you'd exspect. They can do so much to help us these days. Chin up, hugs Jo 😊

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Quote: “He was nearly given drugs intended for other patients on 2 occasions and offered drugs it then transpired he didn't need after being told by a nurse that he needed to read through a leaflet and make the decision himself if the meds were something he thought would help....surely it's a doctors job to decide on appropriate meds no a patient who's mental thought processes are impaired due to his heart rate. We'e been left with zero confidence on anything we have been told.”

I’ve had this experience in the U.S. with meds with similar names, which could have liked me. “Quinine” and “Quinidine”! I NEVER feel I’m in “good hands” nor do I trust any doctor. That’s why I came to this site, to read for information!

You have to take responsibility....it’s darned hard, researching and keep a medical dictionary handy! Then be as pro-active as possible! I’ve had bad outcomes, because I was just too sick to do this though. It’s not easy. Everyone needs a personal advocate to go with them....take notes as,to what the doctor says, because you WONT remember later.

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Hi Aberon1,

I am sorry to hear that your dad has been experiencing these symptoms. Your dad’s diagnosis of LVSD translates as ‘Left Ventricular Systolic Dysfunction’ which means his left ventricles is not working as well as it could be. The atrial flutter means he is in an abnormal heart rhythm with delayed electrical activity (known as a block). There is information about these on our website and NHS Choices. to describe tests involved and treatment options available.

Also if he experiences increased symptoms and chest pain, it is important to seek medical attention and call 999.

It is a good idea for him to keep a symptoms diary as has been suggested as this will provide a lot of information at his follow up appointment. I appreciate that this is a difficult time while he waits for his appointment, but please do make contact with his GP and even the consultant via their secretary if he has questions/concerns in the meantime.

Take Care,

Emily

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Was he given a blood thinner, or is he able to take such?

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Hello all,

Thank you so much for your replies, they are all very helpful and have made me feel slightly more at ease that we can make positive steps ourselves to move forwards with some kind of plan.

I have discussed a diary with Dad and he has agreed that it is a great idea so that is something we will definitely be doing.

We are going to wait for a few weeks to give the meds time to start to work and dad to rest a little then chase up the appointment with the hospital but in the meantime are going to see his gp or speak to his consultant to clarify re his meds and some of the terminology and timelines we have been given.

In terms of medication he has been given amiodarone, rivaroxaban and bisoprolol fumerate. He's not feeling great on them but his heart rate has come down from prevously a resting rate of 140 which the hispital were struggling to control for 5 days to now being in the 60/70's which is a great relief for now!

Thank you so much

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One month ago, when the couldn’t get my heart rate below 130-150, and while on monitor in ER, it dropped to 30bpm, then back up again (In Ecuador) I was given a pacemaker. I’m doing better! I had brief bout of V-tachy 350bmp (dangerous) and was,restricted from coffee/caffeine. But when that seemed lame, I went to another cardio who gave me Rythmol.

I’m doing better! I came here, because my Pace Maker is used on Europe, but not approved in U.S. by FDA.

Hoping to get info.

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