Q&A with BHF cardiac nurses: got a qu... - British Heart Fou...

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Q&A with BHF cardiac nurses: got a question? Let us know!

Helen_BHF
Helen_BHFAdministrator

Hi everyone,

We know there’s been lots of unanswered questions on the community over the past few weeks, so our team of cardiac nurses wanted to open the floor and give everyone the chance to put your heart health questions to us.

A lot of the discussion on the community recently has understandably been coronavirus related. Don’t forget, you can find our pinned post with some FAQs about coronavirus and useful links to information here healthunlocked.com/bhf/post...

Please post your questions below by 5pm on Sunday – we may not be able to cover all questions but we’ll be sharing a Q&A video with answers next week!

The video will also be shared on the BHF’s social media channels and website (we won’t include any names) as we hope it’ll be a useful tool for heart patients outside of the community too.

Thanks all!

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35 Replies
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I had a heart attack last October and had a stent fitted I am isolating at home with wive an two sons my older son wants to take a job in a factory they have all the protective clothing on he has is own room an bathroom at home is this ok.

Philippa_BHF
Philippa_BHFAdministrator
in reply to Robster12

Hi Robster12,

Thank you for your question.

As we are still under lockdown, it wouldn't be advisable for your son to start a new job at the moment. Although it is great that the factory has equipment in place, you are still at risk from developing complications if you were to catch coronavirus. The most important factor currently is to adhere to the government guidelines of strict hand washing and social distancing and self isolating at home if you develop any of the symptoms associated with COVID -19. You may alsowant to have a look at the pinned posts we have attached to the HealthUnlocked site.

Take Care,

Philippa

I am getting conflicting information.

I should be in the vulnerable high risk shielding group as I am a severe asthmatic, I am on Mepolizumab, Tiotropium, Fostair 200/6, Montelukast, I have high blood pressure and taking Candesartan, Co-Amilofruse, Doxazosin. I had a heart attack last August + 1 stent and taking Ticagralor and Asprin.

I had a chest infection early March and was on antibiotics, I was taken into hospital with chest pains on 23rd March and during the course of examination was swabbed for Covid which tested +ve, luckily it was a mild bout of the virus. I have isolated at home for 7 days and my wife isolated for 14 days.

The question is, now that I have had the virus am I allowed out? Do I still qualify as vulnerable and need to continue shielding?

I am being told on 1 side yes I can go out as now that I have had the virus I have some immunity against it and I need no longer be shielding. I am also being told as I am in the vulnerable group I must stay indoors and continue shielding.

I was waiting for my letter which had still not arrived by 20th April, although I did contact the asthma consultant and my GP and was finally sent a copy from my GP that arrived 22nd April.

I was on sick leave from 16th March re the chest infection and went straight over to furlough leave 27th March, but will I have to wait 12 weeks before I can go back to work?

I am a caretaker at 2x local churches, so I do mix with other staff of about 30 and members of the public from time to time during my work time.

Dear TuckBox2,

Many thanks for posting your question. I think it is great that you have received a letter from your GP as this would provide some clarity on the risk category or group within which you may fall. As COVID-19 is a new virus, there is still a lot we are learning about the virus and with time we hope there will be more evidence to shed light on immunity against the virus.

With regards to how long you should be shielding, I would suggest you refer to the specific guidelines or instructions provided in your letter as your clinicians are more aware of your full medical history and would usually offer advice and guidance based on this. However, if you are still unsure of when you should be returning to work then I would suggest you contact you GP via telephone if possible, to discuss this with him/her.

Hope this has been of some help.

Kind regards

Barbara_BHF

My GP doctor does not work for Corona virus.

Cardiologists diagnosed me after the last angiogram as roronary artery disease, RFA - JL4, JR4, Williams. I'm not going anywhere for the Corona virus. The UC review agency convinces me that doctors are wrong that this is serious. Is it normal or, abnormal? I need a lawyer for the healthcare industry. I have no energy.

I had a stent in a coronary artery 2013, single cabg during open heart surgery, from mammary artery 2019. Also new aortic valve.

Now I have a mended heart, do I still have coronary heart disease?

Presumably no longer aortic stenosis either?

Above a reply to Helen- BHF

i was previously diagnosed with MVA.. unfortunately was taken to hospital on Sunday after several days of chest discomfort both at rest and when moving around..and underwent a CT angio.. Cardiologist said no major obstruction but moderate ‘furrring of arteries’.. also advised i have angina and IHD.as i was advised that MVA involves tiny arteries that wouldn’t be visible on a CT angiogram... does this now suggest that MVA has been replaced with unstable angina? i forgot to ask her that question

Philippa_BHF
Philippa_BHFAdministrator
in reply to Manhattan1

Hi Manhattan 1,

I'm sorry you've been troubled with these symptoms. Where your doctor has identified furring of the main coronary arteries, this can cause angina symptoms that can come on at rest or exertion, similar to MVA. As you have now been diagnosed with ischaemic heart disease(IHD)it is really important to slow down the furring up process as much as possible.

It may sometimes be difficult to differentiate between the two types of pain as everyone is different, but the advice would be the same. It is really important to continue with your medication, keeping an eye on your blood pressure and cholesterol levels and to manage a healthy lifestyle as best you can by taking regular exercise, eating a healthy balance diet, managing stress levels and not smoking.

If you find you are needing to use your GTN spray more regularly or if it is not being effective, please make an appointment to see your GP.

If you have an episode of chest pain that isn't relieved with rest or GTN please ring 999 for an ambulance.

If you want to talk this through further please ring the heart helpline to speak to one of the cardiac nurses.

I hope I've helped.

Take Care,

Philippa

Milkfairy
MilkfairyHeart Star
in reply to Philippa_BHF

Hi Philippa

What about INOCA

Ischaemia no obstructed coronary arteries which is discussed in the European Society of Cardiology's guidelines in the management of Chronic Coronary syndromes?

escardio.org/Guidelines/Cli...

There is a confusing interchange of terms.

Microvascular and vasospastic angina are classed as as types of Ischaemic heart disease by the leading BHF funded researchers into this type of angina eg Prof Colin Berry.

Non obstructive coronary artery disease. NOCAD

Background : I have prinzmetal angina also known as variant angina. I was diagnosed when I had a Vasospasm in my LMS whilst having an angiogram - I was literally in right place right time. They put a stent in immediately. 6 months later I had a stroke behind my eye and lost some peripheral vision in my left eye. This was 4 years ago aged 45. I’m on a lot of medication including 150mg aspirin and clopidogrel.

My question is this - Am I being utterly bonkers drinking a couple of glasses of wine a few times a week? Since lockdown I’ve found myself enjoying a drink in the evenings but tonight have had a massive angina attack and put two & two together? Or am I wrong ? Look forward to your reply . Xx

My pulse went down to 48 or 49. Last night resting. I am a 54 yr old female.on a 25mg levo dose for thyroid .have been for 2 years my GP says its in range..but does only basic test.

It has been running in the 50s at night at rest not at sleep but at rest last night was at the high forties 48 and 49 and my blood pressure has been running highaverage lately 140/98. this is very concerning to me. :-(. Yet my doctor doesnt seem a bit concerned! At his office this week 160/108..went down to 140/98 within 20 minutes. I am some overweight and i am working toward being more active and eating healthier.

Trying to stay positive but my body seems like it's not cooperating.

I also have Eptopics. I can feel the skipped or extra Beats. Sometimes skipping a beat averaging one per minute for a few minutes then returning to normal. Sometimes feeling like it's multiple fast beats then after several LONG seconds straightens out. I seen a cardiologist less than 2 years ago who said everything was okay except for mitral valve prolapse with some regurgitation. I am concerned about walk and such because I understand it lowers your heart rate, goodness do I need my lowered anymore?

But im having so many issues. And as of current I have no insurance.

Sleesa
Sleesa
in reply to Autumn822

I'm no doctor but I did have low pulse rate and high blood pressure for some time. It took me years to get referred to a Cardiologist. All I can tell you is diastolic is the part they'll be concerned with mostly and 98 or 102 is high. Not horrific but certainly high.

A year ago I changed surgeries and saw a new gp. She referred me to a a cardiologist. Her opinion was that some docs just assume its white collar syndrome. She also said that men cardiologists dont always understand womens symptoms and assume it's other things eg hormonal.

See a new doctor and insist on being taken seriously. Buy a machine. Write down your BP morning, lunch and night until you go.

When you do get referred insist they take it seriously.

My BP was ranging from 129/98 to 149/101 I'm now on a diuretic and a calcium channel blocker for the BP and Isosorbide mononitrate for the 3 narrowed arteries they found after a scan the first doc didn't think I needed!!

You may be fine and it may be white coat syndrome but given you've other symptoms it needs investigating further.

You may not be able to answer this question and I do understand that everyone is working really hard. However, I would like more clarity about how hospitals are choosing vulnerable people for shielding and what they are doing about other patients. I would be interested to know if there are guidelines for hospitals about how to advise patients, particularly those who are not in the shielding group but have been left frightened and uninformed. We have had no contact at all and my husband is feeling rather forgotten. He has severe heart failure following LAD heart attack two years ago which he wasn’t expected to survive. He now has two stents and a pacemaker. He is also type 1 diabetic. He is usually seen by the consultant every six months. So far all he has had is a letter cancelling his next appointment. We are on tender hooks actually half expecting a DNR letter from the GP, because it seems to us he is on the scrap heap and it doesn’t feel much like anyone cares about whatever group he is in.

Hi.

I was told, just before lockdown, I have 3 narrowed arteries but no more info was given.

My Cardiologist is fantastic and rings me every week to check my BP is OK and readjust my meds as I'm quite sensitive to meds.

My question is would I be allowed to be home if it was serious? If it was a widow maker would they have told me immediately?

My cardiologist just said, "I've seen worse". I mean it's a bit vague. She did also confirm it was CAD. That in itself terrifies me.

She doesn't appear at all concerned, apart from obviously getting my BP meds sorted.

How common is it to have 3 narrowed arteries? I was due to have the angiogram when the covid-19 pandemic kicked off. The ct scan showed narrowing.

Any advice?

Hi.

I have aortic stenosis with mild regurgitation.

I was meant to have been seen for a yearly check up but wasn't. When I visited my GP they wrote to my cardiologist and I never heard anything back from them.

My symptoms have been a bit worse recently and I don't know what to do.

I just feel that I am not a priority at the moment and something serious will need to happen before they see me.

Any advice?

Thanks in advance.

Hi there ! Just wondering how safe is it to attend upcoming hospital appointments for check ups, as I am one of the shielded category. All the usual tests being carried out that means being close to about three different staff members and should I wear a mask?

Thank you

Izzyg

MichaelJH
MichaelJHHeart Star
in reply to izzyg43

Currently before each appointment the majority of hospitals contact the patient beforehand. If you haven't heard a week before ring then to check. This results in either a cancellation (to a later date), a telephone appointment or a face to face appointment. I had an appointment last Monday for a diabetic eye screening as impossible over the phone. The hospital areas between CovID and Non are well separated with plenty of PPE in use. The waiting area was well stripped with only four patients on an area usually with 30 - 40 people. If essential you can be accompanied but no family outings. Shopping is probably riskier now that proper precautions are in use. I have an MRI next week and not attending is not really an option!

izzyg43
izzyg43
in reply to MichaelJH

Hi Michael JH

Thank you for your reply, I will ring ring them and find out, like you say you can't have ECG, and Echo cardiograms at home. I was just concerned with the amount of different health professionals within this short space of time. I am sure I am just worrying about nothing.

I'm complicated. I have fibromyalgia, severe spinal spondilitis, trapped nerves in various places, sjogrens syndrome, peripheral neuropathy and heart attack 18 months ago with two stents. I was told damage was "minimal" but I have two more part blockages in the LAD that were about 60%- not bad enough to stent. I only take 1 furosemide, aspirin, simvastatin and ranitidine. Plus oxycodone every 3 hours for the pain. In January I started having terrible difficulty breathing. Like a tight band around under my bust preventing me from taking a deep breath. GP has only seen me once to listen to my chest and heart. He sent me for an emergency x ray to look for a compression fracture then had me using GTN to see if it helped- it didn't then increased my ranitidine in case it was reflux related. The difficulty breathing has continued ever since.I'm scared it could be the two other blockages but every time I ring the GP I just get a phone call back. NO one ever checks me out in person. They are now just guessing. I've increased ranitidine, tried buscopan, tried GTN spray, increased ranitidine . Nothing helps. I'm now mouth breathing and struggling. Surely a GP needs to see me and at least get these other two blockages checked?

Philippa_BHF
Philippa_BHFAdministrator
in reply to Qualipop

Hi Qualipop,

If you are experiencing symptoms such as shortness of breath or chest tightness it is always advisable to call 999 for an ambulance, A first responder will be able to quickly assess you, and decide the next best step. I know it's a worrying time for you, but it really is important to seek emergency medical assistance if you need it.

Take Care,

Philippa

GP just insists it's either my stomach or my spine. Three different GPs have been saying that since January. Some days' it's fine, other days I really struggle. I'd just like to see a GP in person and at least get my chest checked out.

I had surgery to repair a mitral valve , replacement of a quite leaky aortic valve, and a hole [VSD] that was mended from childhood just over 3weeks ago. Apparently all went well. Ive managed to get hold of the re hab team as the hospital I had the surgery in wasnt local . Of course everythings up in the air due to coronavirus but I think I may have located some online stuff.Just before this I was advised to do some walking of about 15mins per day and build up gradually. Im fine with this as I have been a walker for some time and was walking with moderation and not as far before I went in hospital

I started doing short local walks at slow to moderate speed last week tryin to avoid inclines as I don't live in a flat area but was surprised how difficult it was as it was liked I had never walked before. The walks probably lasting about 20 mins or so but got quite breathless . Ive also started moving about the house doing some housework but nothing that involves weight. Am I expecting too much too soon?

I've just had a copy of a letter sent to my GP with the results of an echocardiogram done in March to access my LV function following the commencement of Entresto in February. LV function appears to have improved from just below 35% to around 40% which is good but it also shows a flash of colour across the interatrial septum. I was due to have appointment with the heart specialist to discuss Entresto and the finding of 'potential interatrial communication. I can't see much information anywhere on this ( perhaps as well as I usually scare myself to death when I google anything like this!) but I am obviously concerned at this new find. What does it all mean and what action is likely to be taken? My follow up appointment has been cancelled due to coronavirus and heaven knows when I will get a rearranged appointment. I'm concerned whether things will worsen without getting seen but there again surely I would have been contacted if it's something bad so perhaps I shouldn't be too worried but it's hard not to be.

Philippa_BHF
Philippa_BHFAdministrator
in reply to aqualates

Hi aqualates,

I'm sorry you've got these concerns re your echo report. Medical jargon used in hospital test results is a common cause of anxiety and as you say googling doesn't help find the answer! Although your appointment has been cancelled, many hospitals are offering virtual appointments with specialists, so you could see if this in an option by contacting your cardiologist's secretary.Your GP may be able to offer you some reassurance too, so perhaps see if you can have a phone consultation with them in the first instance.

I hope I've helped.

Take Care,

Philippa

Thank you, I have a virtual appointment with my cardiac nurse on Thursday so should hopefully be able to find out more then.

Hi, thank you for your support. I am quite anxious as I have atrial septal defect and enlarged right side of heart, with a left to right shunt and I think they said right sided heart failure. I am very breathless and get tired easily. I can’t even walk 400 yards or do simple housework without it taking ages to recover. I am waiting for closure of the ASD but I am in between the consultant taking me of his car and the specialist accepting my care and am in no mans land with it all. My concern is would it be likely that once I have had the hole closed, should I be fairly back to normal with regards to being able to do walks and housework. My hole is 1.2cm. Thanks. Lindsey x

I was diagnosed with FH ( familial hypocholestemia ) in 2012 was put on 40mg Atoravastatin, am type 2 diabetic, 2018 had a heart attack and stents 2 in LAD and 1 in the circumflex, Artovastatin up to 80mg also asthmatic, my pharmacy can’t get my statins and I haven’t had any for 4 days , I spoke to the receptionist at my health centre and she said it’s only a statin it’s not life threatening, it was quite upsetting really as it’s the FH thatProbably caused my heart attack . And with the worry of Covid 19 and having to go to

work. I am on aspirin, bisoprolol, isosorbide, furusomide. Artovastatin, codydramol. Ramipril.ventolin.fosfair.omeprazole.gtn spray,

I had an echocardiogram which found a trivial mitral regurgitation. The doctor said it's basically nothing to worry about, vivid wasn't around then would this still be the case?

Thanks

Ray

Philippa_BHF
Philippa_BHFAdministrator
in reply to Bicyclist

Hi Ray,

I would be reassured by this result especially if it was the only abnormality reported. Many people have this, have no symptoms because of it or require any treatment. It is seen and noted by the sonographer who did your echo, but needs no further investigating as it stands. Depending on the reason for your being sent for the scan in the first place, your GP may want to send you for other investigations if you have any symptoms that trouble you.

I hope I've helped.

Take Care,

Philippa

Thanks Philippa, that was just about a year ago now, I had an letter from the doctor saying fine but if I wanted to discuss further he would be happy to do so. Thanks for your reply, much appreciated.

Ray

Hi Helen

Question 1

I am currently at 10mg Bisoprolol with a H R of between 60/70 BPM Previously it has been down to 33 BPM so Bisoprolol reduced to 7.5 mg from 10mg. My Blood Pressure started to change significantly so Bisoprolol put back to 10mg. So question is does Blood Pressure follow Heart Rate or is it the other way around ?? Need to re-phrase that if your blood pressure drops will your Heart speed up to help compensate, and same if Blood pressure increases will Heart Rate Drop ?

Question 2/3

I am on Entresto at 49/51 mg I have not had a blood test for the last 4 months.

If Entresto affects Kidney Function is this a slow process or a very sudden decline ?

Bonus is since starting Entresto Ectopic Beats have gone from a High Burden ( Cardiologist Assessment ) to Almost Non- Existent are you aware of this change in people on Entresto ?

Background Male aged 72 I have an EF in low 40s %

MI in 1982 Total but distil occlusion Left and Right Stenotic Arteries

CABG in2015. Circumflex and LAD . 2018 Two Stents in by passed LAD . RCA 100% blocked Risky to clear.

NYHA Class 3 ( Heart Clinic Assessment )

Heading for Entresto at 97/103mg oh and QRS is widening.

From 1982 MI until 2015 no medication not even a Aspirin.

Take Care and Stay Well

Philippa_BHF
Philippa_BHFAdministrator
in reply to Prada47

Hi Prada47,

Thank you for your questions. I would suggest you contact your GP to request a blood test to ensure your kidneys aren't being affected as a result of the entresto as it has been a while. It's impossible to say how long it would take for any damage to occur or in what way. When you next have a follow up appointment with your cardiologist , they may be able to give more information and recommend further investigations if they though it necessary.

In regard to both your questions, everyone is different in the way their body reacts to medication, alterations and its effects, hence the importance in regular check ups and reporting of any new symptoms or side effects. Apologies for not being able to be more specific, but I hope I've helped.

Take Care,

Philippa

Helen_BHF
Helen_BHFAdministrator

Hi all,

Thanks for all your questions, you can view the answers from our cardiac nurses in our video here: bit.ly/3aW3nR8

We hope you’ve found this helpful, we’re always looking for feedback so please let us know by emailing heartvoices@bhf.org.uk or leave us a comment in this thread.

Any questions that haven't been answered in the video, will be answered by our cardiac nurses within the community next week.

Thanks!

Hello, How r u all. I am.39 year male. I have heart problem last six years. 5 year ago dr did my EPS ( ablition ). Now from five years my issue is

" when i do any work like walk or bow down and then take rest , my heart face very much difficultly to become its normal place , i can not explain in words how much worse i feel".

Many tests done many psychologists and cardiologist check me. In short they did my Angio Graphy. Dr said u have minor CAD it will be treated with medicine. I attach my angio graphy report.

Now again i do little work and same bad condition i am facing. I stay on bed..its feels my cardic will arrest or it going to fail.

My life is like hell. I can not enjoy life.

Please tell me is my heart weak? Do I need thalium scan? What i do?

Please give me your suggestion.

I will be thankful to you.

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