Nurse Q&A session now open: Hi everyone... - British Heart Fou...

British Heart Foundation

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Nurse Q&A session now open

Philippa_BHF
Philippa_BHFAdministrator

Hi everyone 😊

I’m a Senior Cardiac Nurse at the BHF, here to answer your questions. Please do pop your questions in the comments below and I’ll do my best to help!

Before we start, please avoid posting the real names of the doctors or nurses treating you, or specific hospital teams. We may close this thread at any time if we feel the conversation isn’t in keeping with the ethos of the community – here’s a reminder of our community guidelines healthunlocked.com/bhf/post...

If your question doesn’t get answered today, please do email hearthelpline@bhf.org.uk. You can also call our heart helpline on 0300 330 3311, weekdays 9am - 5pm, Saturdays 10am - 4pm.

We know many people are experiencing delays and cancellations of appointments, surgery and tests due to the coronavirus. Our page explains some commonly asked questions, and who to contact if you need more support: bhf.org.uk/informationsuppo...

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21 Replies
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Hi Phillippa, potentially, Can refractory angina cause re - current costrocondritis ? Thanks

Philippa_BHF
Philippa_BHFAdministrator in reply to Boo_boo1

Hi Boo_boo1,

Thank you for your question. There doesn't appear to be any evidence to suggest this, although for those living with chronic chest pain from either condition may appear to mimic the other which may in turn increase anxiety levels. Your GP or specialist should be able to prescribe medication to relieve discomfort although this may be challenging due to anti inflammatory medication not being recommended if you are also living with coronary artery disease.

I hope I've helped.

Take Care,

Philippa

Also, can substantial weight loss improve EF ?

Philippa_BHF
Philippa_BHFAdministrator in reply to Boo_boo1

Hi Boo_boo1,

Thank you for this post too! Weight loss will help to take some of the strain off the heart, as will reducing blood pressure and the overall work the heart has to do in order to pump blood effectively around the body. It should always be done very gradually if there is a need for a significant amount of weight to be lost, though, rather than crash dieting as this rarely works, as well as resulting in low mood due to depriving yourself of food you enjoy and the nutrients we need in order for the body to function properly. Keeping to a healthy weight, the blood pressure under control, regular exercise and taking any medication prescribed to help the heart pump more effectively should all ,have a positive effect on the ejection fraction in the long term.

Philippa

I had an echocardiogram but on my discharge letter there was no mention of the EF rate. Is that common? Thanks

Philippa_BHF
Philippa_BHFAdministrator in reply to Heartattackvictim

Hi Heartattackvictim,

Thank you for your post. I hope you are feeling ok after your heart attack. An echo report reports the EF as a percentage as opposed to a rate - it's the force of contractility at which the heart is pumping each time it beats. It will never be 100% as the heart is continually contracting and relaxing, so anything over 49% is deemed 'normal', but there are other ways of measuring the the heart's pumping ability as well. If you need to discuss the findings of your echo report it would be a good idea to make an appointment to discuss it with your GP, cardiologist or cardiac rehab team.

I hope I've helped.

Take Care,

Philippa

Hi,

I have a Bicuspid Aortic valve which isn't quite at regulation to be treated. I am running and training for a half marathon. I was wondering if the running could deteriate the valve at a quicker pace? I don't suffer any problems when running or after.

Thanks

Philippa_BHF
Philippa_BHFAdministrator in reply to PacemakerTitan8

Hi PacemakerTitan8,

Thank you for your post. If your condition allows you to exercise at a moderate intensity and you are doing so safely, without causing you any symptoms, I can't see how it can do undue harm to the valve, in fact, it is more likely to contributing to improving your heart's overall health, but it would be better to double check with your cardiologist if they are happy for you to do so. If you are being monitored by your specialist and having regular echocardiograms as they recommend, this will be the most efficient way of checking for any deterioration. If you do however experience any new symptoms in the meantime, please seek their advice.

I hope I've helped.

Take Care,

Philippa

Hi Philippa

Should I go ahead with a flu jab if I am having an AF attack at the time?

Philippa_BHF
Philippa_BHFAdministrator in reply to Bluesometimes

Hi Bluesometimes,

Thank you for your question. If you are feeling unwell while it's happening it may be better to wait until your heart rate settles down, especially if you are having symptoms such as breathlessness and palpitations . There are many people who are in AF all the time, and if they have been invited to receive it we would want them to have the jab as long as they feel well otherwise. In fact, some places such as pharmacies offering flu jabs are taking the opportunity to check people's pulses at the same time to see if their heart rate is irregular, the first sign of AF, as a way of identifying those who have yet to be diagnosed. Many people don't know they have AF as there aren't always symptoms, so I feel this is a good thing.

I hope I've helped.

Take Care,

Philippa

Hi Philippa, thanks for the opportunity to ask questions. I had a stent in August after an HA. I also suffer from Adenomyosis that causes more pain and stress than having an HA. I’m trying to stop my cycle so I can properly recover and get my health back, but have been waiting for my gynecologist to contact the cardiologist to contact my GP to get the go ahead on taking hormone medication with my heart medication. Do you know if Prostap or Zoladex is safe to take with the normal heart meds?

Philippa_BHF
Philippa_BHFAdministrator in reply to Blue-Rocha

Hi Blue-Rocha,

Thank you for your question.

I'm so sorry to hear you're having to juggle recovering from a heart attack as well as trying to cope with the adenomyosis. I can't find any evidence to show it would interact with your heart medication as such, but Zoladex may increase your cholesterol levels, which your cardiologist may want to keep under control as part of the secondary prevention side of your post heart attack care. I'm afraid it still comes down to your specialists deciding on the safest option for you though. In the meantime, you may find it useful to talk to your local pharmacist as they are often easier to see to talk to face to face these days, especially with everything that's going on with Covid- 19. They will also be able to access your prescription and let you know if there would be any potential harm to you.

I hope I've helped.

Take Care,

Philippa

Hi Phillipa

Don’t know wether you will able to help but I have been off bisoprolol now for 8 weeks and still getting multiple palpitations all day every day, (very often 10 or 12 a minute) I have an ILR fitted and waiting for an appointment at the palpitation clinic but everything has been out on hold again.

I just wondered if you had any idea how long rebound palpitations will last after stopping bisoprolol

Philippa_BHF
Philippa_BHFAdministrator in reply to Nannyknitting

Hi Nannyknitting,

Thank you for your question.

I'm sorry you're still having problems with rebound palpitations after stopping the bisoprolol. I'm afraid I don't have the exact answer as it's different for everyone, but I know it's a common problem- you may get some replies from others here on the site who know what you're going through though. Your GP, cardiologist or nurse specialist may be able to prescribe other kind of medication to reduce the number of palpitations you are having on a daily basis, if in theory the bisoprolol itself has been eliminated from your body.

I hope you feel better soon and that I've helped.

Take Care,

Philippa

Hi Philippa

I have had a heart attack and heart failure.They done angioplasty and done one stent.I am 50and not sure if I should go back to work as my journey is on London transport Buses and not an easy journey as I live in a semi rural area .Due to COVID am I very vulnerable and should be working from home? I had this 3 weeks ago the journey is about an hour and a half what would you suggest? Also does heart failure get worse ? I have read that some people only live on average 5 years?

Philippa_BHF
Philippa_BHFAdministrator in reply to Holly787

Hi Holly787,

Thank you for your post.

I am sorry to hear you've had such a rough time recently. If this only happened three weeks ago, it's still very early days, so I would suggest you take as long to recover as you need gradually building your activity levels and taking your medication. Make an appointment with your GP to discuss repeat prescriptions for your pills, returning to work, travel and also have a chat with your employers about the safest way for you to do both. If you have the option to work from home this would be better. Everyone is at risk of catching the virus, so as long as you follow the government guidelines and limit your contact with others as much as you can, your risk of catching it is lower and therefore the likelihood of developing complications from it too.

The stent will have improved the blood supply to the heart muscle and although there may be some damage , it has been diagnosed, which means it can be monitored and treated with medication. By making changes to your lifestyle if you need to, such as regular exercise and keeping your blood pressure under control and having regular reviews, your doctors will be able to keep an eye on your heart's muscle function even if this means drug dosages increase to improve things over the long term. This is a safe and effective way to control your condition and is part of the national guidelines for heart failure management.

Please don't focus on the time span. Many people are able to live well with heart failure and are able to improve both their condition and quality of life- it isn't a one size fits all condition.

You may want to have a look at the bhf.org.uk/informationsuppo... hub for further advice and support. If you have not been referred to your local cardiac rehab service, your GP should be able to do this for you. Although cardiac rehab services aren't currently running a face to face service due to Covid-19, you can still contact them for support. You can also ring the Heart Helpline to speak to one of the cardiac nurses if you need to speak to someone in the meantime. The number is 0300-330-3311.

I hope you feel better soon and that I've helped.

Take Care,

Philippa

Hi Philippa

Apparently my heart only runs at 25/30% will this ever get better?What I the do’s and don’t regarding drinking ,exercise and anything else?

Philippa_BHF
Philippa_BHFAdministrator in reply to Holly787

Hi Holly787,

This is where the follow up scans of your heart, cardiac rehab and medication should help, but I can't give you the absolute answer I'm afraid as I'm not involved in your care. With the dos and don'ts you will find everything you need on the cardiac rehab at home hub and you can also sign up to the weekly email programme , so you can monitor your progress and feel motivated as you go along. Do try and get involved with your local cardiac rehab team too. They will be able to do an assessment ( most likely either virtually or with a phone call) and then you'll be able to set your own individual goals regarding your long term health. Good luck and please do call the helpline if we can be of any further help, or if you would like to speak to someone in person!

Take Care,

Philippa

Hi Philippa, I've suffered from heart failure for a couple of years now and was gradually improving. About 4 months ago I was diagnosed with CKD stage 4 and my heart is 2/3 NY Scale. Medication has been a nightmare. Ive had ultrasound and kidneys look ok. Im on renal diet but no kidney meds. But over the last month I have been breathless again and its quite scary. Ive never been given GTN spray. Would it help? My BP is low usually 80/50 and my oxygen 88% . I have telephone appointment in about 5 weeks with h.f. nurse and have been trying to see gp or talk to her without success and im on y own.

Philippa_BHF
Philippa_BHFAdministrator in reply to Love101cats

Hi Love101cats,

Thank you for your post.

I'm sorry to hear you're experiencing these symptoms.

GTN spray is usually only given to help relieve the chest pain symptoms of angina. It is short acting and not used in heart failure management. Although it sounds contradictory, an intravenous version may be given to some heart failure patients in hospital as it reduces workload on the heart, but always in a very safe controlled way. The spray usually works very quickly and causes a rapid drop in blood pressure as it affects the smooth muscle cells of the coronary arteries to the heart and cerebral arteries in the brain which can make people feel very light headed. Your blood pressure is already low, so this wouldn't help you feel any better I'm afraid.

If you are feeling worse, please call 999 so a first responder can come to your house to assess and treat you. It may be an idea to try and contact your HF nurse as well if she doesn't know your breathing is getting worse- she may be able to review your medication and inform your GP of her actions.

In the meantime if you would like to speak to one of the cardiac nurses on the Heart Helpline to talk things through further, the number is 0300-330-3311.

I hope you feel better soon and that I've helped.

Take Care,

Philippa

Yes thanks for clearing up gtn spray.

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