Should I ask for a echocardiogram? - British Heart Fou...

British Heart Foundation

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Should I ask for a echocardiogram?

MrsSuzuki profile image
23 Replies

I'm in A &E at the moment having started with short, sharp chest pains early this morning. My first lot of bloods come back ok, troponin just 6, awaiting results of second trop result.

I had Nstemi, angiogram and stent fitted December last year. Pain was nothing like I had today. I've been back to A&E twice, Feb and March since my stent was fitted, with chest pain, not as severe as today, but was told it was gastro problems. I do get wind coming up, but the chest pains today feel much worse.

I'm just worried if my trops come back ok, along with my chest x-ray, they will send me home and wondered if I should ask for an echocardiogram as I'm worried if my stent is failing?

Sorry for the long post, I'm really worried today

Thanks, Lily

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23 Replies
10gingercats profile image
10gingercats

If you think it might help you to understand what might be going on ask for it. If they say no ask for the reasoning behind their refusal.

Kristin1812 profile image
Kristin1812Heart Star

I’m dont think an echocardiogram will show if your stent is OK. But to be sure, why not ask what test they could do that could check if it’s OK.

Hello :-)

No one knows their own body better than themselves so if you feel no matter what the blood tests come back as everything is not ok then yes ask and they may try to talk you out of it but stand your ground and let them know you feel no matter what the tests maybe coming back as you feel everything is not ok

Good luck and let us know how you get on :-) x

tortoiseowner profile image
tortoiseowner

I would ask so they know you are concerned, they may be able to investigate or at least tell you why they don't think that is the issue.

meadfoot profile image
meadfoot

Ask them and if they refuse question why they think it isnt necessary or important. In this world if we dont push for our own health no one else will. Please dont be fobbed off or sent home without answers and a plan of action.

Sometimes we have to dig our heels in. Best wishes.

MrsSuzuki profile image
MrsSuzuki

I'm still waiting to see if a cardiologist will see me. Trop levels are ok but still have occasional pains . They may refer me to chest pain clinic so will have to wait for appointment, so might not get to see the cardiologist .

Worried that when I get home I will get pains again. It never ends.

Thanks for your replies

Lily

MrsSuzuki profile image
MrsSuzuki

They just tried to send me home as they said they would send me an appointment in the post for chest pain clinic.

Told them I'm not happy and want to talk to someone so now waiting. Been here 6hours

in reply toMrsSuzuki

Have they done an ECG yet? Its relatively easy to do assuming the equipment is at hand and there are those in A&E who are qualified to do it although interpreting the output is down to the cardio people (in my experience)

I'm no expert, I've had two echocardiograms and on both occasions I've had them done the person doing it was quite chatty, mine weren't done under stress.....I was led to believe that they could monitor the function of the heart...is it pumping ok and are the valves working correctly....but they couldn't actually see if an artery was blocked.....Whatever, I hope you're ok.

MrsSuzuki profile image
MrsSuzuki

Yes two ECG s ok. Saw nurse cardiologist to try and reassure me. Doesn't think HA. Only thing not checked is liver function so waiting for blood results. Still a bit of pain, I'm nearly one hundred percent it's not a gastro problem but what can you do. Echocardiogram not on menu today unfortunately , but I'll keep taking the tablets.

You can't do much to find out whether it's your heart that's giving you problems without the intervention of health professionals, But there is quite a lot you can do for yourself to find out whether your chest pain is gastro related, especially if you are already being treated for it. So typically.....

First off keep a food and drink diary. Do you get discomfort after eating certain foods or drinks? Citrus fruits, spicy food, lots of strong coffee, alcohol especially spirits, lots of onions, chocolate could all be triggers and there may be others.

Do antacids help?

Do you get discomfort if you bend down a lot, as in say decorating? If so that could be a hiatus hernia.

Do you get problems if you eat large meals?

Do you feel choked after eating?

Do you regurgitate food and/or get an acidic taste in your mouth.

If you find that none of the above makes any difference then it may not be gastro related as you suspect, but you will have some evidence to present to the medics to support your view and perhaps challenge theirs.

MrsSuzuki profile image
MrsSuzuki in reply to

Basically no to all your questions. I really struggle with PPI's and aspirin, my stomach is quite tender, so I am still thinking it could be gastro related with wind coming up. The pain was different this time, felt like more sharp pains in my heart, which made me go to A &E. Thanks for your reply.Lily

in reply toMrsSuzuki

If you believe aspirin to be causing you stomach problems and you are taking dispersible aspirin switch to entero coated or gastro resistant. And if you have a sensitive stomach and take ibuprofen or any other NSAID for pain relief especially on a regular basis you should stop and use paracetamol instead. But as far as PPIs are concerned they are usually prescribed to settle things down if you have any form of reflux disease (like me) and/or take some forms of medication, so PPis shouldn't, as I understand it, be causing you gastro problems they should be making your situation better, although there may be other side effects to contend with.

Milkfairy profile image
MilkfairyHeart Star

"if ECG and trop levels are fine then the chances of anything cardiac are very low."

Your comment above isn't accurate.

Many patients who live with non obstructive coronary artery disease caused by microvascular or vasospastic angina can have normal ECGs with small rises in troponin blood levels.

Some people who have a heart attack have no or minimal ECG changes.

Microvascular and vasospastic angina are more common in women and are under recognised and difficult to diagnose.

Ongoing chest pain after stent insertion is not uncommon. The stent may treat the visible obstruction to reveal an underlying problem in the function of the coronary blood vessels due to microvascular dysfunction or vasospastic angina.

acc.org/latest-in-cardiolog...

MrsSuzuki profile image
MrsSuzuki in reply toMilkfairy

Thank you for that post. My ECG's were normal and trop levels quite low too when I had my Nstemi.

Yesterday ECG's were ok and trop levels very low too at 6, then 7. The cardiology nurse checked liver and the results came back ok, as did everything else.

She had another chat with me to try and reassure me that after consulting the cardiologist, they didn't think it was anything to do with my heart .

By this time, 8pm, my pains had gone, and she thought it could be a gastro problem, seeing as over the past few days my stomach we was tender and I'd been burping a lot with wind (nothing unusual for me there as I do have problems with PPI's and aspirin), so I was was sent home.

Normally I have bits of pain in my sternum which I am sure is wind related, but yesterday the pain was short, sharp and painful on the left hand side to my sternum, making me worried that it was my heart.

Tried sleeping sitting up last night, a bit uncomfortable but no pain today so far.

I'm still glad I insisted on seeing someone with cardio experience who did listen to me.

Just to say that my husband rang 999 when I was getting the pain and was told at least a 6 hour wait for an ambulance near Lincoln. Suffice to say he dropped me off at A& E an hour later and to be fair I was seen within 10 minutes.

Thanks to all who replied.

Lily

Milkfairy profile image
MilkfairyHeart Star in reply toMrsSuzuki

I am glad to hear you feel more reassured.

I agree you did the right thing by going into hospital to be checked.

Perhaps keep a log of your symptoms? Chest pain at rest is a sign that there maybe a problem.

The latest research by Prof Nick Mills is suggesting that any troponin blood level above 5ng/L is significant. Women also have lower troponin blood levels when they have heart attacks.

There is also growing awareness that angina can occur after stent insertion even surgery.

I hope you feel better soon and more at ease.

Heartsofoak profile image
Heartsofoak in reply toMilkfairy

Hi, I've had 22 srentd fitted and just completed s triple bypass and aortic valve replacement 10 weeks ago. All is great now, never felt better, but in all this time (1998 - 2022) all of the many ECG 's I've had have been normal.

Milkfairy profile image
MilkfairyHeart Star in reply toHeartsofoak

Just goes to show that ECGs are not always that accurate in picking up ischaemia or lack of blood supply to the heart.

Great to hear you are doing well.

SPV123 profile image
SPV123

If you are in a Hopsital surrounded by Doctors and people who know what they are talking about, i really cant see much point coming on here to ask for opinions, sorry to be blunt, hope you feel better soon,

in reply toSPV123

SPV123

That's a very 'old school' approach, and may suit you but it certainly doesn't suit me. Whereas medical professionals are usually right about their diagnosis when confronted with a health condition presented to them, everyone has a right to challenge that diagnosis if they believe it doesn't fit, especially since as we get older we all get to learn about our own bodies when something is wrong. Unfortunately I have been in A&E on several occasions in recent years and have observed how pressurised most of the staff are, and that leads to quick decisions, which may not necessarily be the right ones, especially if there is ambiguity involved. And the system is also under pressure through sheer weight of incoming numbers to get people processed and hopefully back out the front door, and that also leads to quick decisions. Finally I have had several conditions throughout my life where the medical professionals have not got it right or simply just didn't know, fortunately nothing majorly life threatening. the latest being a recent diagnosis of angina when presented at A&E, which as I am finding out turns out to be gastro related and nothing to do with my heart.

Milkfairy profile image
MilkfairyHeart Star

Would you please be able to share with the forum your lived experience of heart disease?

It will give context to your response.

Your response continues to contain inaccuracies

Anybody can copy and paste from the internet.

Milkfairy profile image
MilkfairyHeart Star

An ECG is also very dependent on how accurately the stickers are applied too.

I have had lot and lots of ECGs and they are as you say open to interpretation!

Suzyh profile image
Suzyh

See your GP and ask for a referral back to your consultant. Thats what I have done

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