British Heart Foundation

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Very surprised

I use this forum for myself usually but am surprised why I am here this time.

We had a very eventful day on Wednesday after going to A&E so my husband could get his blood pressure taken, (on the advice of 111) you may think that is a very unreasonable action for blood pressure but something definitely wasn’t right. We couldn’t get past our Drs receptionist she just said go to a chemist who equally didn’t want to know so A&E it was. After a two hour wait we saw a nurse who took his blood pressure, she quickly went and got a Dr who didn’t initially believe what the nurse was saying until she saw it and checked herself. My husband's heartbeat was fluctuating between 25/30 bpm, and every now and then went down to 20bpm. The upshot of it all is that he has a complete heart block and is now in hospital waiting for a Pacemaker.

They are monitoring him very closely and with a drip keeping his heart rate between 35/40. They moved in the early hours of Thursday morning to a bigger hospital that could cope better with his problem. He hasn’t had a heart problem so they are a bit baffled as to why he has this and why he looks and feels so well. Needless to say, I am so glad we followed our gut instinct and called 111 and went to A&E. I don't really know much about heart block so any input would be more than welcome.

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Mirador19

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Hello

I am so amazed with Doctors at the moment they seem to not have the time and maybe they don't but if we did not have the sense to phone 111 or go to A&E it makes you think what could happen

I am so pleased you did and he is now in the right place and once he gets that pacemaker in he will be up and running as we say

Keep us updated how he is getting on and take care of yourself x

Thank you BeKind28, he looks a bit better already with the medication bringing his heart rate up a little bit.

That is good to hear and he will be home soon x

I am surprised your GPs surgery could not check your husband's BP. Ours has a monitoring machine in the entrance. Can you change your GP?

I am tempted to move.

Sadly it is possible that there were no medical or nursing staff on the premises! My husband went into our GPS a urine sample checked and there were only the receptionists there. I wouldn’t have liked to be a receptionist in those circumstances!

I was told in Sept 2020 to buy my own monitor and monitor it myself

We have 2 monitors and neither of them would work on my husband, part of the reason we phoned the drs initially, they both worked on me but we couldn’t get any readings at all on my husband.

I asked them to recommend one , they wouldn’t so asked my local pharmacist

It wasn't the BP monitors that these people had that were at fault, it was just that BP monitors use your pulse to determine your BP. When your heart is in total block it isn't pulsing properly at all so normal BP monitors won't work! Yes, it really is as 👀 as this and soooo fortunate that these good people went to A&E!

So glad to know your husband is now getting some decent treatment. Your GP(and Co) deserve an almighty wigging for what amounts to professional neglect. Do think seriously about moving to another practice.

To be honest we have only seen the dr once since we moved to this area 2 years ago. When my husband is home and we’ll again I think that we will look to see what other practices are close by.

That's an extremely poor response from the receptionist.You have the right to make a complaint to the surgery, I would be contacting the practice manager and giving him/her details of the event, if dissatisfied with the response, contact PALS.

I've used that service before which had a very positive outcome.

Do you really think it warrants a complaint?

If they had no available nurses to do a BP, they did the right thing by suggesting the Pharmacy, as they had no one available then the only option would be A&E!

Not sure what more you would expect?

I would expect better than that. And it certainly does warrant a complaint

You don't say what you would expect?

I think some peoples expectations are not in line with NHS guidelines.

I would expect the receptionist to seek advice from someone medically trained in the first instance.And talking of NHS guidelines, they state that if you're not satisfied with a service, or lack there of, complain to the surgery, if you don't agree with their response, take it to PALS or even the ombudsman.

But if there are no appointments the receptionist is correct and seems to have followed the correct protocol! Speaking to someone who is medically trained won’t change the answer.

Surely if it’s urgent then an Urgent Care Centre If one nearby or A&E is more appropriate than a GP Practice anyway!

Taking someone's pulse takes just a moment, being sent to a pharmacist, then A&E could have had serious consequences.Not only would someone have taken mine in the surgery I belong to, but would also have called an ambulance if they thought it necessary.

I've encountered receptionists "protocol" as mentioned in the post.

I thought it was BP, my mistake.

I did notice your mistake 🙄

From the OP

“We had a very eventful day on Wednesday after going to A&E so my husband could get his blood pressure taken, (on the advice of 111) ”

You're very argumentative aren't you. I heard there were trolls on here

Lol how is pointing out that you are wrong argumentative?

I'm not wrong, the problem was his pulse, not his blood pressure, but we are obviously not going to agree. So I suggest you just jog on and bother someone else, unless you're enjoying the trolling of course 🤔

You are wrong, re-read the OP, it says a few times that they wanted a BP reading.

Calling someone a troll for pointing out you’re wrong just makes you look stupid.

☺️

I'm labelling you a troll because I've read other replies you've made and your argumentative nature.

And now you are trolling, quite amusing.

I would say discussing only becomes an argument when the person who is wrong isn’t man enough to admit it 😉

Trolling is when someone makes a point and the troll thinks they know better and won't go away. Sound familiar?

Ah so you say “problem was his pulse, not his blood pressure” I say you’re wrong, so you call me a troll, not the definition of a Troll that I would use!

Really? I'm sure Dr Google would like to contact you for advice, as you seem to know everything.

Not at all, but I can read and am man enough to admit when I’m wrong, unlike you.

Your not worthy of anymore replies so feel free to chat with yourself.

Have you run out of answers? And the word is free, not feee

You don't need to thank me for correcting you btw 👍

Gosh, when are you going to stop. These things be. we don't need all this

Why don't you ask the troll that question?

They did ☺️

You are trolling.. Go away

What I have posted is none of the following -

"In Internet slang, a troll is a person who posts inflammatory, insincere, digressive, extraneous, or off-topic messages in an online community, with the intent of provoking readers into displaying emotional responses, or manipulating others' perception."

No what you say is worse...

Ah because I dare correct someone who is wrong, interesting take 🤣

My last reply, have a lovely weekend.

What you have just posted is ☺️

????

What's that about?????

Whit ?? Life is so cheap these days I guess. No nurses available perhaps to take BP ? The very least you can expect is to be heard and listened to. Advised to stay put in the GP surgery to wait for a GP to fit you in … check your BP and … in this case send to hospital. Basic stuff …. It’s one thing to take your own BP and quite another to understand what the devil you’re reading !! Life depends on prompt attention … or maybe I’ve got that wrong now too !!!

Would expect a basic service at all times from every GP practice, They get paid enough. Complain vigorously and get action.

Patient Advisory Liaison Service, PALS is the way you can raise concerns about hospital care.

To complain about a GP's service you can complain directly to NHS England or to the surgery's Practice Manager.

Wales, Northern Ireland and Scotland have different routes.

You can only contact the Parliamentary Health Service Ombudsman once the final resolution to a complaint has been made by the organisation involved.

It's a very long drawn out process.

ombudsman.org.uk/making-com...

nhs.uk/using-the-nhs/about-...

As I stated earlier, complain to the practice manager first, then PALS, or the ombudsman.

PALS is how you complain to secondary hospital services, not primary care such as GPs, Dentist or Pharmacist.

This information is clearly laid out in the links I provided.

That's useful info to have Milkfairy, thank you.

Yes thank you Milkfairy I know my daughters want to complain but I think for now just want to concentrate on getting him well and back home.

I am pleased that your husband is now receiving the care he needs.

My mother in law unfortunately had a poor experience recently too.

I had tried to persuade her to get a Cardiology review as she was having blackouts, has Atrial fibrillation, and symptoms of heart failure. The GP refused and prescribed anti sickness tablets.

Long story short, she ended up in hospital after falling again. This time she'd had a heart attack, her ejection fraction was below 40%.

She now has a CRT-D inserted and feels so much better.

She has changed GPs!

Having had to make a formal complaint about my care in the past, I know that it can be very stressful and arduous process. I fully understand your reluctance to make a complaint.

However, I wish both you and your husband well.

Thank you Milk Fairy, I hope your mother in law is feeling much better now.

Oh goodness! Pleased to hear he’s being looked after now.

The BHF website has articles on heart block, here’s the link

bhf.org.uk/search?keyword=H...

Best wishes to you both.

Thank you Shar28, today is a quiet day for me so I can read some of these articles and comments properly.

That sounds very scary. I'm glad he's getting the care he needs now. So difficult to see a GP these days.

I've been to my local A & E 3 times in the past 2 years and the only time I've been triaged before anything else was the last time when I was brought in by a paramedic so bypassed the normal entrance. You must be very fortunate in your local hospital. The receptionists at my GP's surgery are all lovely, but you still can't see a doctor when you ask to. I have to wait 3 weeks for a telephone consultation with mine, and that is about my blood pressure. Today's NHS is a postcode lottery.

I can ALWAYS get a same day appointment if it's necessary. I first get a phone call from a nurse who decides if I need to see a doctor. If I need to speak to a specific doctor then yes it's a 2 week wait but anything urgent is same day and usually face to face.

Lucky old you Qualipop. As I said, it's a postcode lottery these days.

I'm well aware of that but ours have been pretty good right through. Not all appointments need to be face to face but I had several right in the middle of you know what.

I used to be a Drs receptionist years ago and that is the system we used. It worked well and took the pressure off of the receptionists.

You both must have been so worried… knowing something was seriously wrong and yet getting no where fast by all those you should turn to !! I’m flabbergasted quite honestly. Is there no one left on frontline services that errs on the side of caution ? ? I’m glad for you both that somethings being done now me wishes for a speedy recovery 🌹

Firstly are you sure it was a BP reading? Griff-64 seems to disagree and thinks it was a pulse reading!

Where does the receptionist say "she doesn't want to know"? The only reference I can see is "We couldn’t get past our Drs receptionist she just said go to a chemist"!

If there are no avalable appointments and no way of 'squeezing' any more in, then this would be the correct signposting to ensure the necessary care.

Hi Mirador19. Your husband is in the right place and I hope he gets the right treatment he needs. You also take care. Chris.

Well done Mirador19 for having the common sense AND courage to phone 111 and go to A and E. There are many on this forum who would stand and clap for what you have done. Time and time again it is the patient that has to stand up and demand attention. Many of us reading your post will feel stronger and be more Pro active. 🙏

So glad u went with your gut and went to a+e. Good luck and best wishes x

bhf.org.uk/what-we-do/news-...

Dear Mirador19

You cannot beat Dr Gut Instinct, and thank God you both didn’t.

Please complain about the terrible treatment you have encountered trying to help your husband.

I am not one for pointing the finger at someone or calling for someone’s blood, but lessons can be learnt by mistakes as long as they are reported in the right way.

At the moment you have more on your mind and rightly so, both of you are in my thoughts and prayers.

Take care and please keep us informed.

Oh my goodness I didn't think it would create such a response as this. As most of you say my husband is in the best place and once the problem was found he has received exceptional care. I don't like to make waves so we probably won't complain but next time we need to deal with the GP surgery it will be mentioned. I am lucky that I have a really good cardiac nurse so I bypass the Drs when I have a problem. I am hoping my husband will get the same backup as I have so future issues will go to his nurse first. I still have faith in the NHS but am not sure what has happened to GP surgeries over the past couple of years. I am hoping they will get back to normal and appointments a bit easier to get.

Thank you for all your replies.

Oh dear so sorry to hear your troubles but hopefully he is now being treated well. The thing about GP practices is that they are NOT emergency services. Consequently there may well be times in the day when doctors and nurses are not present.. Even a duty doctor may well be off the premises. Now we can argue whether that should be different but it is a fact at present.Clearly there are issues with both GP services and A and E but they are both under extreme pressure. I have always supported the presence of a G.P. as triage at A and E but there are not enough G.P.s to do it. This is a huge system and logistics problem that needs re- working, recruitment - and yes - more money spent. A receptionist, when being told BP needs checking, would not regard that as urgent - many 111 conversations end up with - see your GP. This is a systemic failure not just the GP Practice. In the meantime what do we do? Ensure you have some 'tools' e.g. BP monitor at home but then I'm afraid A and E is the only option. Let's not fight amongst ourselves please but press for systemic action and improvement.

Well said, 🐘! 👏

You didn’t think it would create such a response as this … that’s what happens sometimes … don’t be put off. Wishing your husband all the best!

Glad he is getting the care he needs. If you want to know more about heart block why not give the BHF nurse a call? You will find them very helpful.

Thank you Sing-Song.

Good morning Mirador19. This need for suddenly needing pacemakers seems to be more common than you realise once you have a pacemaker. I always check my blood pressure every week and 3 years ago at the age of 63. I found my heartbeat had dropped to 45. I was diagnosed with full heartbroken. And had an emergency pacemaker fitted after it dropped to 28. It's a minor operation that only takes about an hour. And I hope he will be feeling better once he has his pacemaker. Brian

Thank you for your reply. We were totally surprised by the whole thing, anyone looking at him would have thought there was nothing wrong with him but I was noticing a few things that just wasn't right and I wasn't happy to just leave him any longer.

Yes I was the same. My heartbeat was 28 when I was rushed into hospital and my doctor said I should have been on a stretcher. But I felt just fine. Hope all goes well for your husband. Brian

Thank you Brian, I’m sure he will be fine once he has the pacemaker.

Can I just say we phoned 111 after being told by the Dr's receptionist to try the local chemist for a Blood pressure reading, the chemist didn't have any appointments to do it and will be closed until next week. So we then phoned 111. Sorry if my post wasn't clear

You have my sympathy. I am glad it has turned out OK in the end.What is happening here is that reception staff are being asked to triage patients. I really don't think this should be happening.

It's clearly not the receptionist's fault. Currently primary care (GPs) are in a poor state. It cannot be right for a receptionist to triage patients. It has happened to me on more than one occasion.

My Gp (very young guy) wanted me to go to A&E. BP was 230 over 117. However he must have been a little garrulous that day and told me the consultants did not like getting referrals from GPs, as they felt patients for this problem (and my husband with the same complaint as yours) should be treated in the surgery. So you have a young doctor, pretty much on his own, faced with a patient possibly about to have a stroke. He could send me home with a new prescription but maybe it would not work fast enough, or face a ‘complaint’ for sending me to hospital. He decided to face the complaint from the consultant, who was in fact extremely rude to this patient too. I definitely wanted to make a complaint about the consultant. As it happened his SHO (took a proper case and listened to the patient) sent off for the very blood tests I should have had and I finally found out what was wrong. Even she looked embarrassed by the consultants behaviour. If he was my kid he would have been subjected to some form of discipline. It’s great, consultants have always been ‘Gods’ in ‘their’ hospitals but now it seems they also have too much clout in the GPS surgeries too.

Hi Kelling. I think you're really lucky being triaged immediately. I'm in London and recently had to take my 93yo mum to A&E. It was just under 2 hours before we were triaged.

3 years ago (before that which cannot be named) I was taken by ambulance (on a Thursday afternoon, with a suspected heart attack) to a different London hospital, and waited 4 hours before being triaged, then another 4 hours before being seen by a doctor, who eventually got me transferred to the cardiac ward for a 24 hour stay.

It’s actually astounding that medical professionals on the whole don’t actually believe people at times! End of the day each individual knows their own body! Hope he’s ok & continues to be ☺️

I have bradycardia and had heart block. Pulse was 25 bpm. Pacemaker made a huge difference and keeps my pulse above 60.

Oh thank you, that’s what I wanted to hear. my husband has slept a lot and had absolutely no energy so he will be so pleased that the pacemaker will make a big difference.

Yes. Very easy surgery. I actually passed out because of heart block and hit my head and got a concussion. That was no fun😵‍💫

Oh no, at least we got to the hospital before anything like that happened.

I just want to offer you reassurance as someone who has suffered total heart block. Most importantly, I wish your husband well, and wish you well too. All I know is that total heart block occurs when the electrical signals within the heart, which communicate with the heart and tell it when to beat, fail. Was your husband feeling tired before or had he noticeable slowed down, or did he suddenly feel unwell? The good news is that it sounds like your husband did not lose consciousness - this will be pertinent for post op recovery as if you have not passed out you can usually resume driving a week after the pacemaker is fitted rather than having to wait for a check up appointment. My pacemaker was fitted with basically only the discomfort you would expect if someone was pressing down heavily on your chest, I certainly wouldn't describe this as pain. I was able to satisfy the surgeon's curiosity as to how I had ended up in his hospital while he was inserting and wiring the pacemaker to my body and then closing and cleaning up. Three years on, I easily can forget that the pacemaker is there and I have my full strength back. I am sure the hospital will monitor him while he waits, but please reassure him that the operation itself should be nothing to be afraid of and he should be as good as new afterwards. The only post op checks are an annual test of the battery life which takes about 15-20 mins and is painless. Batteries should last for around 10 years.

That sounds amazing, my husband has been sluggish for about 2 months but the past two weeks he hasn’t been able to do much at all. As far as I know he hasn’t passed out or fainted at all but he has grown very weak which was one of the things I noticed and it didn’t seem like him at all. Thank you for this information, I have had a heart attack and stents and suffer from unstable angina and small vessel disease but total heart block was totally new to me. He will be pleased to hear that he will get his energy back.

Gosh how scary for you both. So glad you followed your instinct. Hoping for a good recovery. Take care both.

Thank you, he is being very well cared for in Hospital.

Good to hear. Wishing you both well 🌸

There has been much discussion about the response (or lack of) by your GP and the receptionist. I will not add to that. Instead I want to reassure you. I have one of the several types of heart block and had a pacemaker fitted in March this year. Unlike your hubby I had no symptoms but my heart block was picked up by a 24 hour monitor. My form of heart block only happened at night so I was unaware. Pacemaker was required and I am fine. I expect your hubby will be too. I know that my pacemaker is there to do it's job whenever it's needed. Rather reassuring! Please ask if you have any more questions. Best wishes to you both.

Thank you so much, hopefully he will have the same response to a Pacmaker as yourself.

So glad you followed your gut instinct - I’m not sure I’d still be here if I hadn’t - sad times when we can’t access GP services properly , I’d advise anyone with heart concern to just go to A and E - best wishes

Just to add - I made a formal complaint to practice manager as there was just so much wrong starting with diagnosis over the phone of rotated cuff injury - the response took 4 months as they had to contact all the locums , the reply was 12 pages long that I received just before my bypass , I still haven’t read it , just felt it was pretty pointless , I’d made my point and needed to focus on the op , recovery and future . I moved surgery straight after my visit to A and E

I hope your husband is getting the care he needs and will make a speedy recovery. Sad to see so much "doctor bashing" on this forum though. They are human too and coping with a workload that is increasingly unsustainable.

I do agree totally. Once my husband saw a doctor at the hospital I could not praise them more. They acted promptly and really made sure he was being looked after admitted him straight away.

I only know of 3rd degree or total block from having some 2nd degree blocks. It usually follows from 2nd degree Type II blocks gradually getting worse but can come on more suddenly.

I'm so pleased you went to A&E and got some help but am staggered that there was a delay until a pacemaker could be fitted, although once under larger hospital care this isn't a problem, other than a worry and hassle for you.

Pacemakers are brilliant and if he was fine without one he'll probably seem bionic once he's got one!

Look up the Arrhythmia Alliance forum on here for a post just over a month ago entitled

Living with an Implanted Cardiac Device

On the 28th April there was an online event all about them and if you go to the post and register you will be able to see it. I thought it was well worth it.

I wish you both as well as possible as soon as possible!

Fantastic reply, thank you!The "old" method used to struggle to measure mine when it went too low, the new ones struggle if mine doesn't beat enough.

Thank you so much for explaining the difference.

Just out of interest, have you any actual experience of taking a person's blood pressure by listening to the changes in the sounds heard with a stethoscope as the blood pressure cuff is deflated?

It is a skill listening to these changes.

Much like midwives using a traditional pinards steoscope to listen to the fetal heart rather than using a sonic aid.

Or are you just quoting from the internet?

Thank you! 👍

Never heard of this before. You must have been so distraught not to be able to get help from your GP. The last thing you need with heart problems. I wish your husband a speedy recovery.

My husband had a sudden cardiac arrest caused by complete heart block at 67. Like your husband he had no previous heart issues - no high blood pressure, cholesterol normal. This was 4 years ago - we’d gone to GPs because he was getting a bit short of breath. Appointment was almost concluded - he looked well, heart sounded fine, lungs fine, GP gave some advice on his asthma. Then it happened. At hospital his heart rate was only 20 bpm, so he had to have a temporary pacemaker to keep him going for transfer to other hospital an hour away. He had a permanent pacemaker put in the next day. Investigations over the next months ruled out usual suspects - Consultant said his heart had almost certainly been damaged by a previous infection leading to heart failure and heart block. So these things can come out of the blue, and we were so lucky to be where we were with GPs on hand for CPR etc. My husband does very well on a combination of medicines to support his heart and Percy Pacemaker, we walk, we cycle (e-bikes), do gardening etc. With luck you’ll find out more as you go along, and hopefully like us get good support from cardiac nurses and others now your husband is on their books. Best wishes.

Thank you, my husband has his pacemaker fitted tomorrow and hopefully he will be home on Tuesday. We do feel very lucky that we caught it in time.

Hi Mirador19,

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If you found any support in this post useful please use the chat feature to reach out to these members privately.

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