cardiologist

[NannyPat1]

can I just ask - lots of people talk about seeing/asking their cardiologist questions but I don’t have one, I had my HA 18 months ago but I was on holiday in Cornwall so went to Plymouth. Apart from a 5 minute phone call 3 months later, that was it! I didn’t get cardiac rehab as the waiting list was too long and it was then decided I was fit enough so there’s only the GP who frankly I think doesn’t know enough and just quotes guidelines at me. I had 3 stents in my LAD and have felt pretty insecure and anxious since then. Does everyone have a cardiologist?

[Chappychap]

"Does everyone have a cardiologist?"

No.

By and large cardiologists work for hospitals, and after we're discharged from hospital then that's it, our relationship with a cardiologist is terminated and we're handed back to the care of our GP. Although to be honest, for most of us, it was a pretty tenuous relationship with a cardiologist in the first place, one or two brief meetings only.

The way the NHS works is that GP's are the "gatekeeper" to more specialised services. We see our GP and they decide who we should see. If your GP feels your cardiac condition is deteriorating then you will be referred to a cardiologist at a local hospital.

This may sound like an unsupportive service, but that's not really accurate. If our heart condition is heart disease/atherosclorosis, which accounts for about 90% of heart attacks, then there's only so much that medical science can do. Going forward we have medication and life style changes, and that's pretty much it.

My (non medical) view is that the biggest issue in your treatment isn't that you don't have a cardiologist (if you need one then your GP will get you one), the bigger problem is that you didn't have the six week Cardio Rehab programme.

Many people on this forum, myself included, regard Cardio Rehab as the turning point. It spelt out in great detail precisely what life style changes we needed to make, and gave us a tailored exercise programme with personalised heart rate limits. It also taught us what our meds are for and why it's so important we take them in the correct manner. And it did all this in a motivational and supportive environment amongst lots of other people in the same situation as ourselves.

I know the BHF (who sponsor this forum) ran an on-line Cardio rehab programme during lock-down. If that's still running maybe you could attend that?

Good luck!

[NannyPat1 in reply to Chappychap]

yes it would have been nice to get the rehab to meet people in the same situation. According to everyone my heart attack was purely genetic as I was pretty fit, petite and with a healthy diet. I did get tested on a gym bike by a cardiac nurse but that was it.

[Lezzers]

Not everyone needs a cardiologist, my husband had a massive heart attack & cardiac arrest. After discharge from the hospital he never saw a cardiologist for 15 years, his condition was managed by the GP with medication, regular blood tests etc. But cardic re-hab is a definite must, I would be pushing your GP for a referral

[Hidden]

Hi NannyPat1, I had a Bypass in September Discharged after my stitches were removed five days post op approximately.

Then, had a five minute call 📞 from one of the surgeon's registrars some seven weeks later. Like yourself, NannyPat when, I attended my Cardio Rehabilitation assessment appointment I was told there was a waiting list so I opted for a quick one to one which consisted of "walking between traffic cones with a heart monitor attached to my chest. "

When that was over that was pretty much it. Have attended one appointment since when I was instructed how to use weights etc. In fairness I have had a call from them since asking me back for another assessment.

However, I'm very fortunate have good support from my partner and Tennis 🎾 friends and I'm already back on court but the present set up must be very hard for some folks in my area who are not as lucky as me.

Quite an eye opener to me that our care is back in the hands of our GP'S but on reflection I suppose that makes sense but like you I'm baffled when other contributers say "speak to your cardiologist ."

Best wishes for your future ❤️ heart health, Denis

[NannyPat1 in reply to Hidden]

Thanks and best wishes to you too. I’m lucky also, great kids and grandkids who keep me active and feeling young. I do aerobics, Pilates, yoga and weights all adapted for us seniors and go swimming too!

[Hrty]

There does seem to be a big difference of "after care" depending on where you live.The chap I see was in the Cath Lab when I had my angiograph and came to see me in hospital the next day just before I was discharged. Because I've had brushes with type 2 diabetes, pediabetic, he asked me if I was interested in taking part in a medical trial (double blind for dapagliflozin). I saw him the following week as part of the trial, and again earlier this week. There is a bit of overlap with him looking after me as part of my rehab and I should be seeing him again shortly as part of thatto go through blood test results, including the ones taken on earlier this week.

With regard to rehab one of the nurses rang me for an initial chat the week after my discharge and then booked me in for rehab classes.

My local hospital has close ties with Royal Brompton which may explain why we seem to have good support before being completely handed over to the GP. With me being a real worry guts and struggling at times with coming to terms with having a HA I've found the support I've had so far really helpful.

[Anon2023]

hi. I had 2 open heart surgeries one after the other, a stroke and endocarditis, all within 4 months. I’m told that I won’t see the cardiologist again unless I have another “event”. I will now get an annual telephone call from a cardiac nurse after I was discharged by the heart failure team. The heart failure team basically started me on medications and after I was stabilised, I was discharged. I did attend cardiac rehab though. I think follow up care is very patchy and disjointed and I think I’ve probably been luckier than most. My GP never offers reviews so I have to chase up my own tests etc for some of the meds I’m on. It sometimes feels terrifying to be left to my own devices but I suppose that it’ll give me confidence to manage my own health and be my own advocate.

[NannyPat1 in reply to Anon2023]

Thanks for reply. You’re right, follow up is clearly patchy but we’re all in the same boat I guess.

[MountainGoat52]

I never saw a Cardiologist as such. The doctor at the cardiac unit where I had my stents (at the time of my heart attack) referred me directly to the Cardiac Surgeon who went on to carry out my bypass op. Three months after my operation I was discharged to the care of my GP, though the cardiac unit at my local hospital was interested enough to carry out tests to determine the cause of my heart attack. I had rehab at the hospital where I had my stents. Three hospitals working together... brilliant! However, as you say, the aftercare provided by my GP practice leaves a lot to be desired and I have had to fight my own corner as so to speak, even reminding them my annual blood test is due. 😯

[Fynndog]

hi NannyPat1 . I’m a mirror image of what happened to you. I was away at the time of HA and went to Portsmouth. No rehab because if covid. Phone call from cardiologist and doctors who appeared flippant.

When I questioned ( my cardiologist) because I kept reading about people having One. I was told that no body had a personal Cardiologist, the NHS does not work like that. We are patched up with stents ( I had 3 . 2 into LAD) and given medication and then handed over to our GP.s

This Cardiologist told me ,”we are here for you if needed but we must first see our GP who will refer us on to a Cardiologist if necessary.”

I had a review by phone about a year later. I was not impressed and paid privately to see one.

Not the best healthcare really. It left me feeling very alone with lots of unanswered questions.

I was very grateful to find healthunlocked and have gained so much from the kind people here.

I wish you all the very best for the future. Xxx

[Getbacktonormal]

Hi , no everyone doesn't have a cardiologist. I do at the moment only because multiple options have been tried rather than stenting do to the difficult nature. If I am all ok on my follow up then I won't see mine unless a further problem occurs. Not sure about cardiac rehab if that's only for heart attack. Mine was angina and I wasn't offered this . Was told take 2-3 weeks off and if I felt ok I could go back to work.

[Kristin1812 Heart Star]

I’m not sure the service is quite as ‘patchy’ everywhere, as people suggest. Part of the difference (in whether someone ‘has’ a Cardiologist) must be the heart problems we have.

I had regular Consultant appointments when my symptoms werent stabilised, and I had interventions, meds changes and referrals to other sub-specialists.

Once symptoms were stable I stopped seeing the Consultant, and just saw my GP when I went with a problem. No regular reviews for nearly 5 years.

I’ve recently had more uncontrolled symptoms, and the GP says she wants to have the Cardiologist’s view, again. So I’m back there soon.

[Hidden]

The system could never sustain every heart patient seeing a Cardiologist regularly. I don't find how it works patchy for me, I've been seeing Cardiologists for over 30 years, year in year out without fail, but, that's down to my problems. My last one was August 2022 and the next in February.

[Flimflab]

Hi NannyPat I think my comments are similar to Chappychap's. I don't think it is unusual to have limited contact with a cardiologist if the case is not complicated.

Except for the actual angiogram and fitting of a stent I only had 2 brief meetings with my cardiologist. The first to confirm I needed an angiogram and a 15 minute meeting 4 months after surgery to check I thought everything was OK.

As the cardiologist had looked at my heart while doing the angiogram I felt he would have identified and areas of concern. If I have any concerns (after a quick browse here) I would be happy asking my GP (by email or phone) and would expect them to pass anything of concern on to the cardiologist.

For me the main benefit of the cardiac rehabilitation team was to give me the confidence to restart exercise. The diet, stress and explanation of medications talks were done through online videos. If it would help I can see if I have a link to these although I think there is similar information on the BHF site too.

After the cardiac rehab classes we were then offered the seniors exercise at the local gym - it sounds like you may already be at this stage. Did the cardiac nurse give you any feedback after you went on the gym bike?

Have fun with the grandkids.

[NannyPat1 in reply to Flimflab]

only that she thought I was pretty fit 🤣 I had already joined seniors exercise class, went swimming, did yoga, all of which I’ve gone back to. I guess I just worry still …

[Colio432]

Hi I found Cardio Rehab a great reassurance you are not alone. I attend through Heartbeat and have been advised you can self refer. I have carried on after the initial 8 weeks and now do 2 sessions a week with them and feel so much better mentally and physically for being there. Good Luck.

[Yumz199725]

Hi Nannypat1.

I am supposed to have a specific consultant that I see but I never see him it's always a member of his cardiac team which is good considering some people don't even get that which is awful 💔. Sorry to hear you haven't had regular checkups I just thought that was normal for everyone with heart issues to be seen every year or to be given an emergency contact number or email when you have any issues 🤔. It seems you have been left in the lurch I'm so sorry 😔.

[NannyPat1 in reply to Yumz199725]

yes it does seem a bit of a postcode lottery as to whether you’re checked up on or not. Just getting on with it as best as I can and trying not to worry overly. Thanks for your reply.

[BuonaSalute0823]

go get a referral from you GP to have a talk with someone like cardiac intervention or a specialist cardiac nurse .. I’m at Royal Brompton & had to ask PALs to intervene the patient advise liaison are there to assist you so maybe ask Plymouth hospital the best way to speak to someone about this