Why haven’t I been examined?

[Mollusc]

After my HA was finally confirmed in a retrospective ecg, I have been put on blood thinners and beta blockers which have slowed my heart rate alarmingly (it’s only 60 without them). I haven’t been seen by a cardiology department or investigated further , so am scared what has caused it and have been left worrying about having another one. I can’t find any examples of people not being investigated after a HA, so am worrying even more. Why have I been left to rot and worry myself sick, I was already misdiagnosed three times by my GP surgery. Cant sleep, hence I’m on here at this time of the morning. So upset, has anyone else had this sort of experience, as I can’t find anyone else who has.

[Kristin1812 Heart Star]

Sometimes it’s a bit of a mystery how services work. Normally, it would be a good idea to speak to your GP, who could explain what happened and whether a Cardiology appointment should be made. But I’m not sure, from what you have written, if you really trust your GP?

[PeterpPiper]

Relax .. beta blockers don’t just slow heart rate, they protect the heart and help it pump better and assist it to keep in shape. Arrange a phone conversation at least with the doc, tell him/her how worried you are, they get paid to listen, it’s thier job .It’s a shock to you I know, as it was all of us.

We are all in the club no one wanted to join but that’s life

Good health to you .. keep taking the tablets

[Mollusc in reply to PeterpPiper]

Hi, it’s impossible to get hold of my GP, cant ring you never get through. I have an appointment with her in a month and a referral to a chest pain clinic,but nobody has given me any further tests, just said I’d had a HA after looking at my ecg in comparison to a previous one.

[Nettekin]

Hi mollusc. Sorry to hear you are struggling. As many of us have found, putting right our heart issues is the part the NHS does very well. The follow up and support, however, is often sadly lacking. We have to become our own medical advocate. Pushing for answers, chasing up checkups and optimising our medications. Of course we have to do this at a time we are most vulnerable. If you have been discharged by your cardiologist to your GP, then an annual check is the norm. Speaking to your GP is your best bet, although I understand you have lost faith in them. Have you considered ringing the BHF helpline for advice and reassurance? With best wishes x

[Mollusc in reply to Nettekin]

I’ve not seen a cardiologist. That’s what I was saying. I’ve only seen a GP, who has referred me told me it’ll be weeks and gave me tablets. No idea what caused it yet.

[SPV123]

I'm no expert but HA is usually caused by blockages in the arteries, reducing blood and oxygen flow to the heart muscle, at least it was for me, I agree that getting answers to our questions can be very difficult, My route to a diagnosis was A&E with chest pain, Blood test for a Troponin score, ECG, then Angiogram and stents at the same time, followed by the usual tablet regime, that way i got a discharge letter with quite alot of detail on it about my condition, Although most of it is in Code, so Doctor Google plays a part in understanding what is written, Hope you get some answers soon,

[Mollusc in reply to SPV123]

I,think my issue seems to be the fact the HA was a few weeks back, not picked up by paramedics and therefore retrospectively found on a subsequent ecg, after three times being told it was ‘normal’.a lot of wasted time has gone on. Saw GP Tuesday got medication, but haven’t been seen by the experts or had any tests.

[Shar28]

Hello, I’d second the suggestion to speak to the wonderful BHF nurses. Perhaps also ask them which NICE guideline your GP should be following for you and quote that to your GP so they know what to do next. The BHF number is 0300 330 3311 monday - Friday 9-5

Good luck!

[Mollusc in reply to Shar28]

Thank you, waiting for a GP call now, but not my own doctor unfortunately as she isn’t in, so pot luck and no faith in them, naturally, after all the errors.

[Chappychap]

Nobody ever gets a precise, definitive answer as to what "caused" their particular heart attack.

Partly it could be a genetic disposition towards being vulnerable for heart attacks, but there are at least fifty genes that seem to influence your risk, with more being discovered all the time. The NHS, except in very rare circumstances, won't run a DNA test on you (although you can pay for a private DNA test). The chief scientific advisor to the BHF (who sponsor this forum) has campaigned for more DNA testing, but so far without success.

Some heart attacks are driven by issues other than coronary heart disease or atherosclerosis, issues such as micro vascular disease. But it's another area that's far from fully understood.

The larger part of the explanation is likely to be life-style. Many experts estimate that 90% of heart attacks are chiefly life style driven, and there's some solid evidence to support that, for example the decline in smoking has driven a significant reduction in heart attacks. But "life style" covers a massive range of issues, it's not just obesity, smoking, lack of exercise, and poor diet, it also includes issues like oral hygiene because there's a strong link between gum disease and heart disease.

It's extremely unlikely that a cardiologist or GP will give you anything more than very generalised comments as to what might have caused your individual heart attack. However, there are some things you can do to help yourself. You should now get an annual cardio check up organised by your GP, you are entitled to copies of the test results and they contain some very valuable pointers, things like your blood pressure, lipid levels, and HbA1c scores. You'll have to do some research to untangle their meaning, but these metrics contain critical clues as to how your medication is working and what you personally need to do to reduce your chances of future heart attacks.

The second area that can help is the cardio rehab course that you should be entitled to attend. Unfortunately Covid means it's on-line rather than group sessions, but these will give you a thorough grounding in your medication and how to implement key life style changes.

Good luck!

[Mollusc in reply to Chappychap]

Thanks, I am just upset that I haven’t been seen by anyone except a GP yet. All my blood tests have been fine except cholesterol of 5.6, which isn’t great. My boss on Tuesday was 117/81. I haven’t yet come across a case of anyone waiting to be assessed for weeks after a HA just seems very slow and I am a severe anxiety sufferer.

[Mollusc in reply to Chappychap]

Bp not boss

[Chappychap]

"I haven’t yet come across a case of anyone waiting to be assessed for weeks after a HA"

There's lots of people, possibly even most people, in roughly the same position as yourself. This forum is full of heart attack patients suddenly discharged and asking themselves "what now, where's the follow up support, surely that can't be it?".

You get your meds, you usually get an annual GP cardio check-up, and you usually get an invite to attend a cardio rehab course. And that's pretty much your lot!

The NHS are fairly good at keeping us alive when we have a heart attack (okay, you could argue they're better with white men than women or racial minorities in this respect), but preventing the next heart attack is, beyond the standard range of medication, really seen as being down to the patient. That's why the cardio rehab is so central to the preventative strategy, that's where you'll get the life style advice, tailored exercise programme, etc.

I know this may sound blunt, but I wouldn't want you to ramp up your frustration and anxiety chasing something that the NHS simply isn't geared up to provide. Unless you're incredibly fortunate in encountering a rare GP or cardiologist who is especially engaged with sufficient time to pursue your individual case, then the only person that will answer the question "what caused my heart attack", is you.

[Mollusc in reply to Chappychap]

Thanks , I suppose I haven’t been ‘discharged’ from anywhere though. I’ve only been seen by a GP. That’s what’s upsetting me, I want all the tests to see what’s going on.

[Chappychap in reply to Mollusc]

"I want all the tests to see what’s going on."

Yes, I'd agree with that. Even if it doesn't all make sense right now you'll learn a lot more over time. In addition you'll almost certainly have an annual cardio check-up at your GP surgery, comparing current metrics with the scores in a year's time will show how you're tracking and where you need to put your remedial life-style efforts.

The good news is that parliament has made it very easy for you to access your medical records, two separate pieces of legislation have clarified your rights to your test results, you may be asked to contribute towards the cost of running duplicates, but that's rare and in any event is never very much money. Indeed, if your surgery has an online facility then you should register and you'll find you can access your records and test results immediately.

Good luck!