What should I expect one year post NSTEMI

[K9ndo]

It’s coming up to a year from my event and stenting, I haven’t seen my GP or a cardiologist since being discharged. Apart from blood tests what should I expect in terms of a check up.

[Happyrosie]

you ought to be called by by your own doc for a medical review and blood tests - and as GP’s are a bit busy and indeed working to rule I expect they are getting a bit behind - so get on to the receptionist. They will probably pass your request to doc who would ask you to have a blood test before making an appointment to see him/her.

[Lowerfield_no_more]

I also had an NSTEMI about six years ago, and during the stay in hospital I had a series of tests/investigations including an angiogram but no stents. I was discharged out of hospital with aspirin (for life), clopidogrel (which I took for a year then it was stopped) and an increase in my statin to the max dose. After six or eight weeks I attended a cardio rehab course arranged by the hospital and on completion I was fully discharged back to the GP. And apart from a subsequent visit to A&E some time later with chest pains, which was wrongly diagnosed by the cardiology team as angina but which turned out to be gastro related, I have never been reviewed or tested or any heart condition since then by anyone, including my GP, although I do have an annual lipid test as I had prior to my NSTEMI. And that's it. So I don't know what you expect. If you feel fine with no heart related symptoms, all I would be expecting is a medication review for lipids and any other meds you take such as 'blood thinners' and BP, and really there is no need to speak to the GP for that, unless you are suffering side effects. But if you have symptoms of something that could be heart related such as chest pains on exercise that is good reason to see the GP, but I imagine you would have already done that anyway.

[Harvist in reply to Lowerfield_no_more]

Sounds like my history almost exactly!

[K9ndo in reply to Lowerfield_no_more]

Thanks for the reply, whilst everything seems and feels good, I was looking for some reassurance from the GP,

[Avagra in reply to Lowerfield_no_more]

Exactly the same with me after my HA/stent in Oct’22.They fix the plumbing and that’s it you’re discharged and attend cardio rehab for a couple of months and left out to dry !The only consultation since has been at A&E to investigate chest pains and I had bloods,X-ray,ECG and echocardiogram.Im waiting for a MRI and the advise I give to anyone is if in doubt visit A&E to be checked out.Some seem to have a good relationship with their cardiologist and others have to do a lot of chasing to obtain results etc.

[BeKind28-]

Hello

You must be feeling abandoned but usually I personally would have thought you would have had at least one follow up appointment however trying to see this as a positive they must feel everything went well and discharged you back into your Doctors care

The blood tests you keep having done tell them a lot so see that as reassuring they must be coming back ok or they would contact you

The only other thing I possibly would do would be to enquire with my Doctors if I needed and follow up

Let us know how you get on x

[K9ndo in reply to BeKind28-]

Thanks I will be asking my Surgery for a review on my first anniversary. I feel good and have no issues apart from the weight loss since I have cutout high sat foods. 😀

[BeKind28- in reply to K9ndo]

Hello

Lovely to hear you feel so good sounds like everything is going well x

[Stentsandrun]

You might be lucky and get a chat with an extremely overweight Nurse practitioner who will ask you what your diet usually consists of and how much exercise you get per week.

One day............

You may also find you have to remind them you should get an annual check up. I usually take my own blood pressure over a few weeks beforehand and present her with the results.

[K9ndo in reply to Stentsandrun]

On discharge from Hospital the experience with my GP practice was not good. They couldn’t find my discharge letters, hence had not considered the blood test regime the Cardiologist recommended I have had to push them all the way. Whilst I have no problem ongoing issues it would be reassuring to have a chat with the GP.

[Stentsandrun in reply to K9ndo]

Reading your Bio it looks like you are taking matters into your own hands very well, good luck with the Park run, it certainly got me back into fitness. Not sure what "regime" the cardiologist recommended? As far as I am aware the NICE guidelines recommend attendance of Rehab and an annual blood test and general health check by you GP.

[Lowerfield_no_more in reply to Stentsandrun]

Relevant NICE post MI guidelines here (as far as I can make out)

nice.org.uk/guidance/ng185/...

Nothing specific about follow-up, except everyone should have a 'future management plan' in their discharge summary, amongst other stuff, and everyone should be offered a copy of their discharge summary. What is in the future management plan is a not defined so my reasonable conclusion it is patient specific. (refer 1.7)

Plenty on rehab including "All people (regardless of their age) should be given advice about and offered a cardiac rehabilitation programme with an exercise component" which clearly does not happen since some people report note being offered cardio rehab. (refer 1.8).

Also stuff on lifestyle (refer 1.9)

[andybarn]

since my stent i had no follow up other than my yearly ‘old peoples’ check up with the nurse and doctor

[PilgrimsProgress]

you should have been referred cardiac rehab - had a follow up Echo - and regular blood tests via GP to monitor Kidney and liver function.. Your ramipril and beta blocker should also have been slowly titrated upwards to maximise secondary prevention...- whilst monitoring for side effects...

[MWIC]

Follow ups appear to be down the pecking order list - if you’ve had no follow up and you’re concerned or want some understanding of how you’re doing get in touch with GP or better direct to Cardiology and ask for it - Don’t think there’s enough focus on understanding the mental health impact of going through this kind of thing and the need to re-establish confidence in yourself - good luck and don’t be afraid to push when you need to

[Stentsandrun in reply to MWIC]

Once you have been discharged from hospital you re in the care of your GP, most cardiologists are far too busy to deal with mental health issues, that is what Rehab is designed for along with the other aspects. The OP has not said if they had Rehab but if people are still not receiving it, it's a very poor show indeed.

[Qualipop]

I just get annual blood tests and I see the nurse for a check on weight, lifestyle etc. Nothing else at all unless I have a problem.

[Stealthyheart333]

just occasional blood tests and yearly practice nurse visit, i still feel forgotten, time for a revolution with the NHS, change from a repair service to a disease prevention service, but dont hold your breath for it to happen

[Fynndog]

hi K9ndo. Better not to expect anything. I didn’t even get the blood tests. I get one a year called a birthday check up. When I complained about not having a cardiologist I was told that no one had one. If you are worried or unwell see you doctor and you will be referred on. I had HE during covid so no aftercare. They did a great job in portsmouth hospital , truly wonderful and saved my life. Unfortunately I was visiting that part of the country , I am certain I would have got follow up care if I’d been resident. Never mind I’m still here 4 years in. Doing my best to do lifestyle changes and if I’m really worried I have been to see cardiologist privately ( I’m not rich but I value my life)

Sometime this month I’m offered my yearly check up , I’ve got to book it. Hopefully things will be ok.

All the best to you xxx

[AAJJTt]

Hi, I had a nstemi type 2, just over 5 years ago. Echo within limits; slight LV dysfunction. Angiogram was ok - no stents, discharged with medication and into rehab.

I completed phase 3 and phase 4 cardiac rehabilitation. However, phase 4 in my area is delivered by a local charity and I can still attend their gym sessions twice a week.

Attend an annual ‘healthy heart clinic’ via my GP; basically what others have described. Blood / urine tests then follow up with nurse practitioner to discuss, etc.

I haven’t been discharged from my cardiologist yet, as I was subsequently diagnosed with atrial fibrillation; this being the main protagonist in my HA (untreated and undiagnosed at the time). Anyway, I did get a follow up echo, which was fine this time ( thankfully) - no sign of the lv dysfunction. Currently titrating off my arrhythmia medication, suspect I might be discharged after this.

I’d enquire with GP to see what follow up or support services are available.