Diagnosis of 4/17 Areas of My Heart including LAD blockage/Angina. Am a bit Lost!

[Rostom]

Hello

I am a 71 year-old woman with a history of Paroxysmal Atrial Tachycardia (PAT) for 20+ years and take Flecainide x 100 mg twice a day. Although getting on a bit I still cycle and am generally fit although I do have other medical conditions.

I was having more frequent palpitations so underwent an ECG Stress test which was stopped after five minutes and later had a call to advise that 4 of 17 areas of my heart are blocked and that I would be listed for an angiogram - but no time frame could be given due to Covid etc.

A few days later my left arm began to 'squeeze' (I have had this previously but failed to act on it) and I rang my GP who asked me to go to A&E, which I did. There, I was told a main artery (LAD) had a blockage and I would be referred to the RACPC (Rapid Access Chest Pain Clinic). A&E gave a diagnosis of Angina (stable). (I have since been advised by a friend that as I am already in the system, the RACPC probably won't consider me).

My left arm is still squeezing and I can be light-headed/slightly dizzy and breathless from time to time.

My questions, if anyone can help are:

I know I have a problem and everything I have read (LAD= Widow Maker etc!) seems worrying. I have no idea of how bad the 4/17/LAD is: do I need urgent treatment?

Can I safely wait without popping my clogs?

I have not been given anything to help with the angina. Should I? As I understand Dr Google (I know, I know but it is all I have!), angina is stable if it goes after medication and rest. I have no medication and my arm is still squeezing at rest.

Although I am not A1 can I exercise (my choice would be to cycle)? Would this be too dangerous? What can I safely do or do I have to sit and knit - or learn to knit in my case?!

Any help would be very much appreciated. I do feel rather lost as what I should do/be doing/what should be done to me!

Many thanks

Regards

[Alison_L]

Hi Rostom. It sounds as though A&E decided it was nothing urgent and chucked you out! However, as you are still getting dizzy, etc spells, and a tight arm, I'd ring 111 now, and explain to them what you've told us. I suspect they'll tell you to go back to A&E.

Good luck xx

[Rostom in reply to Alison_L]

Hi Alison

Many thanks for your reply.

I agree about A and E but it's only when checking out Dr Google etc., that I read that a LAD blockage has another name: The Widow Maker, which does not induce relaxation!

As of today, the arm's squeeze comes and goes and I am only breathless when I vacuumed (so, as my lovely husband says, don't vacuum'!).

I will speak to the British Foundation nurses tomorrow as I understand that they will be great people to explain how I am, what needs to be done and when (i.e. the urgency - or not) and if I can exercise, in particular, ride my cycle - or not.

Thanks for taking the trouble to respond. A new diagnosis is always scary until one gets to grips with it!

Regards

Rostom

X

[Alison_L in reply to Rostom]

Please ignore Dr Google. An LAD blockage may have been a widow-maker until 50 years ago, but then real doctors started doing angiograms/plastys, and you'll find many of us on here have or have had a blockage, and are happily replying to you

As TruckerClark says below, only an angiogram can tell you how much of a blockage there is, and if anything needs doing about it.

I hope the BHF nurses can allay your fears today. xx

[Rostom in reply to Alison_L]

Thanks, Alison_L, Trucker Clark and Ordinary Guy, for your help and advice.

Since posting, I did contact the BHF nurse who advised me to speak to my GP about chasing up the RACPC referral that A & E said I needed and ask him about a GT spray.

I followed her advice and my GP has given me a GT spray - but I have been reluctant to use it as my pain is in my arm and only a little in my chest. I would be grateful if anyone could advise if I should be using it when I have the intermittent arm pain (which, in terms of pain is manageable)...

My GP also offered to chase the Rapid Access Chest Pain clinic (who should apparently offer an appointment for a angiogram within a fortnight). A few days later I received a letter advising of a telephone appointment consultation with a cardiologist in ten days' time. No immediate angiogram! As A&E and my GP told me I need an angiogram, I guess the delay is due to Covid-related stress on the NHS.

I am presuming that my blockages are not serious enough to warrant faster treatment... at least that is what I am telling myself!

I try not to overthink this but when you are told that 'you have a blockage in a major artery' is is of concern!

Could I also ask if you would exercise, as in cycling? I would love to do so but am a little concerned about stressing my heart and/or falling under a bus as I feel light headed.

What would be your thoughts?

Thanks again for your help.

Regards

[Alison_L in reply to Rostom]

Hi Rostom. I'm glad things are moving along. Make a list of questions you want to ask the cardiologist when you speak to them (Do I need an angiogram? When? How serious is the blockage? Can it be managed by meds? What exercise can I do in the meantime? etc).

Until you speak to the cardiologist, I'd be inclined to stick to walking for exercise - maybe 1-5 miles a day depending on your usual fitness. Cycling might put a bit too much of a strain on your heart if it is a bit dodgy!

If I were you, I'd take ONE puff of GTN next time you get a pain, and see what happens. Sit down when you do it, and stay seated for 5 minutes. It opens your arteries so might make you feel faint (when I first got my GTN, I took 2 puffs 5 minutes apart and hit the deck! But it turned out I was having ventricular tachycardia).

[Rostom in reply to Alison_L]

Thanks again.

I will do as you suggest and try the spray and not cycle for exercise.

I forgot to say that my GP has ordered a blood test to see if my statin ought be raised, so I am being looked after!

Other than that, it seems it is a waiting game but I am surprised that an angiogram is not immediately available. Perhaps I expect too much, especially at this time

Thank you.

Regards

Rostom

[Alison_L in reply to Rostom]

I know there's currently a backlog for echoes at my hospital, so I wouldn't be surprised if angios are the same. xx

[Truckerclark]

I’ve had AF for 20 years ,and only last year got 2 stents fitted into LAD ,,, AS BLOCKAGE ,,, I’m not sure how anyone can tell you your 4 out of 17 arteries including .LAD blocked unless you had angiogram ,,that’s how mines was found out ,,,I did do exercise tolerance test at first with ECG & blood pressure monitor ,,,, but that only showed suspected angina ,,, only angiogram confirmed it ,,,, but if yiur having chest discomfort on exercise breathlessness & feeling numb in arms I suspect you do have angina ,,,but you need to see professional ASAP ,,,,,

[OrdinaryGuy]

A lot of points about your health situation to consider. I can only comment based on my 12 years of experience of paroxysmal A/F - I am also over 70. Whatever approach you take practice what I call "polite persistence." In other words chase the different members of the medical profession who are determining what appointments and treatment + medication you are getting. I found building up contact - including e-mails - with the PA's or Coordinators linked to the Consultants/Doctors helped in getting advice and appointments. This is even more important during the current pandemic when it is even more difficult to get appointments and advice. In my case I was on daily Flecainide, Apixaban, Bisoprolol and Symvastatin medication for a number of years but under a helpful Cardiologist (Heart Rhythm Specialist) for a few years now I have had two catheter ablation procedures and this seems to have stopped the A/F events. However I have to continue with the Bisoprolol, Apixaban and Symvastatin - but not Flecainide. None of this luckily has stopped me undertaking the exercise I like including long country walks. It is important to continue with different aspects of your life that you enjoy including sports - walking and cycling - good in my view - unless you are advised otherwise. Best wishes.