When to call for help

[Singingforever]

I am 75, female and widowed. My husband was a GP so I definitely miss the medical advice on tap!

Had PAF for 10+ years but a few months ago it became much more frequent. I have a moderately leaky mitral valve and have just been diagnosed with ischaemic heart disease. When I get AF, I also get chest, throat and neck pain. I seldom have the AF or angina separately - they always occur together.

Here's my query .... here I am on my own in the middle of the night. AF is on the go (not worryingly fast as I am on metopralol) but I have lots of chest, neck and throat pain - do I ring 111 or do I just ride it out, as I have been doing so far? I am anti-coagulated and also on statin and ranolazine.

As this is all new to me I have no way to gauge the seriousness of it. I don't want to waste people's time, but I would also quite like to wake up in the morning!

Anyone been in a similar boat and might be able to advise or support? Thank you.

[Lowerfield_no_more]

In my view it's really simple . If you believe it could be life threatening it's 999. If you are not sure it's 999. Ringing 999 for those reasons is not wasting anyone's time or denying anyone else an opportunity, that's what they are there for. Otherwise take pot luck with 111 or tough it out and contact the GP surgery to see if you can get an urgent appointment.

[cotonh]

Agree with Lowerfield but in addition get this sorted during the day. Go and see a non husband GP and get re? referred to cardiology. It sounds, if nothing else, that someone needs to review your medication and probably some other tests need to be run as well. At our practice now-a-days you ring first thing or turn up at opening time (or before as there is usually a queue) to get a "today" appointment. Then if it is urgent they can refer you directly to hospital in our case to SDEC - Same Day Emergency Care. There is lot of waiting around like in A&E and it usually takes all day for things to get sorted. Take a small bag with you incase they decide to keep you in over night which has happened both times we have used it. Certainly you need to be checked over asap.

You could alternatively ring 111 during the day. They will talk through what is going on and , if they think your symptoms are concerning you will be rung by a clinician. They will talk further with you and they can request your GP practice contact you or see you or tell you to go to A&E or to ring 999. This takes quite a bit of time too and you have to be available from the first contact with them ready to answer when they ring again.

I have rung 999 twice. They are experts at working out what needs to be done. If you don't need help they won't send it but equally if you do need help they will get it to you as soon as you need. You will not be wasting their time and it will help you sleep better knowing to ring and safe you not waking up in the morning.

Make sure they can get in - neighbour with key? keysafe? spare key under pot? Have a small bag packed with what you would need if you went into hospital - list of medication, tooth brush, etc

[Carercmb]

999 every time . Don’t take any chances.

First time this happens you will be referred to the correct people for the answers you are needing to be confident.

111 will probably advise going to AE with the same results but you need to get yourself there

Good luck getting this sorted for your piece of mind.

[fishonabike in reply to Carercmb]

I have used 111 and they have sent a paramedic who requested an ambulance on two occasions - as far as I am aware 111 can send an ambulance too

[Carercmb in reply to fishonabike]

Never struggle alone.

[scentedgardener]

I know exactly how you feel, I've had the same symptoms with some added.I asked at a cardiology appointment when I should call 999, as this nearly always happened with a PAF episode, I thought that a cardiologist would be able to give me a definitive answer, but standard medical advice, call 999 with "if it lasts more than 15 mins" added on.

I was only once made to feel a nuisance, and that was my worst ever episode with the pallor, sweating, nausea, etc all added on, and very frightening.

[cotonh in reply to scentedgardener]

Sorry you had a rotten experience but still perhaps, better to have been and be checked than to have stayed at home anxious and worrying. I hope it will not put you off going again when you feel the need again as it could be a completely different experience next time around.

[Qualipop]

Chest pain = 999. The paramedics won't take you into hospital unless they see something worrying and you are NOT wasting their time. YOu also need to get an urgent appointment with your GP.

[Bismark]

I understand how you feel because before my ablation I used to get minor chest and back pain and felt unwell. I did go t ER once and one of the doctors wasn't happy I was there after the ambulance showed them my ECG and the hospital did blood tests which appeared normal.

I left ER after an hour without them finding anything. When I spoke to my Cardiologist he suggested that I increase my dose of Flecainide from half a tablet 50mg to 100mg and my Digoxin to remain the same. The several times I did this the pain went away and I did feel better. I can only stress though I would never increase my medication unless I had prior approval from a medical expert.