Greetings all,

[Ocset]

After a heart attack and usual meds and all that, how often do people see a cardiologist or have their condition reviewed by their GP? all I get is six-monthly review of blood pressure.

thanks.

[CA5102TER]

1 stent and usual meds and I only have annual blood tests, blood pressure review from local surgery nurse, not even a doctor, but presume I have been really lucky with no complications or side effects.

[Ocset in reply to CA5102TER]

thanks for your reply. same here with BP test.

[Gompa in reply to CA5102TER]

didn’t have heart attack but strange feelings in chest ,jaw and arms.had 4 stents 3 weeks b4 Covid lockdown.have never seen cardiologist since and have a review yearly where I do my own blood pressure checks and have a blood test and that’s it.

[bikerider00]

My experience and my understanding: you should have had various blood tests at set point after discharge (6 months?) and these should then become annual: assuming you are on 'the normal drugs'. Blood tests for cholesterol, liver and kidney function.

As for cardiologist: they wanted to cancel (actually did) my followup appointment post HA, without any explanation ('no longer needed'). Which I was unhappy about. But due hospital admin problems I was able to get to an appointment anyway. Which was a good thing because post HA I had (and am) getting Afib. Anyway, their reasons for thinking it wasn't needed was because HF had returned to normal. So answer to that question for me would have been: 0 times in total if not for.....

[Ocset in reply to bikerider00]

thanks. I also have the blood test but they never offered the liver and kidney function and I did it privately when visiting a friend in Ireland. I asked my GP for a cholesterol test two weeks ago and was told I have to speak to someone first before. Waiting for the call on 8th Jan 2025. I wish I did it in Ireland

[bikerider00 in reply to Ocset]

I'm very surprised by this. You must have discharge notes from the hospital? They should have stated that theses tests should be done. They are standard and are the responsibility of the Primary care provider (my understanding). Also I'd expect instructions on uptitrarting things like your ACE inhibitor and beta blocker. This is if you are on standard meds like that (which is also where the need for liver/kidney function tests come from.

I'd dig out the discharge notes, check them and then bash the GP surgery round the head with them.

Did you get put onto a cardio rehab clinic by the hospital?

I speak as patient, not medical.

[Ocset in reply to bikerider00]

Was discharged to the GP by both Cardiology and rehab team but the surgery is really struggling and this is having a knock-on effects for patients. will chase them next week.

[Lowerfield_no_more]

Your hospital discharge notes after your heart attack will indicate the plan for you. Are you still under the care of the cardiology department or have you been discharged back to your GP. In my case after my NSTEMI a few years ago, my discharge from the hospital was followed by a cardio rehab course after which I was discharged back to the the GP. I was already on an annual lipid plus liver and kidney function test before my HA and that continues, and the only time I get medication reviews is on the rare occasions I ask for them. Noting that I take BP meds I occasionally get asked for a BP reading which I do myself and it then goes onto my notes . Otherwise I am on my own but as I don't feel any need for an periodic check up, whereas there might be someone out there who does need a health professional's input.

[RufusScamp]

I had a pacemaker fitted over four years ago, and all the contact I have is with the monitors, every six months, to tell me I am still alive.

[Mentdent]

Heart attack, stent March 2021. I haven’t seen anyone.

[20thJan]

Its diabolical really that the follow up from heart attacks is so mediocre,my discharge letter states in 3 months i'll see a cardiologist,after 6 months the consultants secretary told me it could be 18 months before i get in front of one? And even then it will probably be a telephone appointment by a trainee cardiac nurse?

I had the widow maker heart attack and you would think that seeing that my hospital is a centre of excellence for cardiology,it would be inconceivable that you are left adrift with the GP having to take the strain, But can't answer all the questions you need answers to??

[L8Again in reply to 20thJan]

My understanding is that following Covid a decision was taken by the NHS to do away with many post treatment consultant reviews. For example, some complex operative procedures now have a scoring system. The lower the score, the shorter the period of post op monitoring.

My wife has a Pacemaker and is on drugs for Hypertension. Her Pacemaker is checked annually by her pacing team, and her GP surgery asks for BP readings and arranges blood tests also on an annual basis. There is no contact with the surgery unless a test reveals that a treatment change may be required.

I appreciate that this is not the sort of NHS that any of us want; however, this is how it is. By way of a single example, we have one of the lowest number of scanners per capita in the World. Even if the Government doubled the number of devices overnight, it doesn’t deal with the fact that 37% of radiology posts are vacant.

This recent report shows that cardiac patient waiting times are also increasing:

bhf.org.uk/-/media/files/wh...

[FarhanH]

Six month checkup with Cardiologist.Echo once in 3 years if no complications.

Cholesterol level checked once in an year.

Kidney and liver function checked once in 2 years. Because BP mecines effect kidneys and liver performance. Urine analysis for protein once in 2 year if no protein found

Thats my cardiologist advised and my routine after HA and one Stent placed in 2015.

[Badger132]

Hi my friend you should be referred to the heart failure clinic and see one of the nurses every six months to discuss how you feel any problems blood pressure check why check and general health

[devonian186]

Every 6 months? Are you personal friends of your GP?

[Survivor1952]

AVR, CABG and 2 stents discharged to GP care. 18 months post surgery. Blood tests only, no reviews at all. Been told there are no appointments available for the foreseeable future to monitor my ‘long term condition’ .

Told by local cardiac unit at hospital I should have an echo by April 2026 as the plan is every 2 years.

[Barre01]

I saw an Advanced Nurse once and then left to go to an annual med review with gp. I did request an appointment with go to review the event - HA. I concluded that what is a major event for the patient, is routine for the medics. They seem be prompted by symptoms eg: breathlessness, swollen ankles

[LilySav in reply to Barre01]

Re your last sentence...the breathlessness etc, even then it's a battle. My OH didn't have a HA but does have other heart issues after myocarditis, COVID and a couple of nights I'm hospital 2 years ago after a bout of unstable angina. Discharged to GP for observation and medication management.Trying to get a GP appointment for guidance re the ongoing symptoms is V difficult and and annual blood tests a massive struggle. They usually give in because I'm such a pain on the bum! If he didn't have a determined partner, he'd be left high and dry.

[MountainGoat52]

Hi Ocset,

After my heart attack when I had two stents, I was referred for bypass surgery and met with the surgeon a month later. The op was eleven months after my HA and three months after my op I was discharged back to the care of my GP.

My GP now considers me to be "fixed". I have an annual blood test followed by a medication review. I take my blood pressure (morning and evening) approximately every ten days or so and submit my results annually to my GP. I never have my blood pressure taken at the surgery as I suffer from clinical hypertension (white coat syndrome) which was recognised by my GP over fifteen years ago.

Initially my wife was concerned about the lack of apparent follow up after my heart attack and later after my op, but myself less so. I am proactive in monitoring my health and feel that the arrangements are adequate for me personally, though additional blood tests would be helpful to monitor my Homocysteine level which was part of the reason why I had a heart attack in the first place. Currently they are not being made available on what appears to be cost grounds.

I hope this and the comments made by others help.

Kindest regards,

Gerald

[Whiteghost]

Hi blood test every year. Appointment with GP to discuss results. Cardiologist signed me off, but if I have any issues I can ring his secretary and we can take it from there. Pretty standard procedure I think. 🤓

[YITOPM]

Unless I go to A &E which I am never happy to have to do, I find it almost impossible to contact my GP surgery and there is no proactive care. Paid for a private ultrasound and found I have gallstones, cholecystitis and steatosis. GP notes say to do nothing until patient contacts them…… never mind the HA, exertional agina, supraventricular tachycardia and angina pectoris I was diagnosed as having. I imagine it’ll all be fine though.

[Alfie33]

Mines 12 months, and I have to push for anything else

[aardvark68]

2015 had widow maker, cardiac arrest and stents. Discharged from hospital after 3 days on the usual meds. - 2 of which were stopped due to side effects. Did cardiac rehab - useful. Now just annual blood tests and BP checks by the nurse.

Which seems to be the usual procedure and is fine with me. The assumption is that the problem was fixed so no further action needed.

[Natali999]

When my mum was diagnosed with AF and had a mitral valve repair. Mum saw the surgeon 3 months after the surgery and then on her cardiologist every 6 months. This included B/P, Echo, BloodTests etc.A few years into that they decided to see mum annually with the usual Echo etc because they were happy with mum's heart health.

So I'd initially think it would be 6 months. Check with your GP.

[Alicant]

Reading through this thread..really shows what a mismanaged and poorly organised Health Service we have..frightening really..and causes us folks anxiety.Needto send some of these “Threads” to Wes Streeting and Starmer!They want to know they said

[Avagra]

I had a heart attack and stent in Oct’22 and have seen a cardiologist just once and that was only because I was taken to A&E 6 months ago with chest discomfort.She ordered a echocardiogram followed by a stress cardiac MRI and I only found out the end results by logging into my NHS app as i received zero response from any doctor.I think cardiology is a postcode lottery and once you’ve had the hospital treatment ( excellent) follow ups are very poor in certain areas .I recommend using the NSH app to obtain medical records.

[Qualipop]

Heart attack and stents 6 years ago; two further blockages not stented. Once a year bloods and check up with GP. Cardiology? Never. The attitude is "We fixed your plumbing, now go away" . I was referred back to cardio by a hospital department October 2023 and again Jan 2024 by G P. Still waiting.

[EastchurchTwentyOne]

HA in Dec 2022. Stent next day a week before Christmas and another 6 weeks later. Have not seen a cardiologist since. Discharged to GP who luckily for me is excellent. I get an annual check with him and have seen him more regularly as despite dietary changes and max rovustatin my cholesterol level not where Heart Centre want it. Just been prescribed Ezetimibe. I’d feel much happier having an annual check with cardiology but much of the NHS it seems has pushed outpatient work to GPs

[Lowerfield_no_more]

This is an interesting thread. Post discharge by cardiology, care provided by health professionals seems to vary between annual reviews with a health professional together with several tests, to annual tests if you are lucky. And people's expectations seems to sit between the need to sit down and discuss their cardio health situation, to a few annual blood tests which confirm everything is about right which is considered enough. Whilst I am certain we are all different, I believe if you are doing OK without any new cardio related symptoms, or ongoing symptoms affecting you quality of life which need to be addressed, it is unrealistic to expect anything other than annual blood tests that confirm things are OK, and if they aren't a review and possible treatment follows, for if everything is OK what is there to talk about?

[JezzaJezza]

I have SVT treated very successfully with dronedarone and bisoprolol. I have full bloods every 6 months and then review them with my GP. I see my cardiologist yearly for a review and a 24 hour holter. My GP checks my blood pressure but in addition I check it weekly at home.

[JH6419]

As someone said in this thread this shows how stretched the NHS are. I really feel for them as the pressure they must be working under must be draining both physically and mentally.

Since 1998 I have had heart issues including a heart attack, stent, AF, ablation and most recently a cardiac arrest on 31 August 2024 which I miraculously survived, another stent and an ICD inserted in my chest. I was supposed to have a follow up with my cardiologist but he was not well on the day of the appointment so I talked to his registrar.

My view on all of this is listen to your own body and if you have concerns contact your GP which can be a long drawn out process so you have to be patient. My outlook has changed since my cardiac arrest as every day I now wake up to I am grateful for and thankful to be around. I try not to think of the situation I am in and I just try to enjoy every day and look forward. While I was having my rehab I got friendly with some of my fellow patients and one of them was waiting on a heart transplant and despite that she was still going to rehab! As I was sitting in reception I heard the receptionist speaking to a person who I thought was a visitor to the hospital and she was asking how she was settling in with her new heart! Both gave me goosebumps and were so inspirational!

It is so natural to be worried about your condition after what you have gone through - all that you can do is to listen to your body, exercise and eat healthily and you will have gone a long way to making sure you have a lot of great years ahead of you. Sorry if I sound patronising but I really feel it is a new mindset that we all need when we have cardiac issues

[cabgpatch]

Had CABGx3 last June and to date have never met my cardiologist. However, I have had a telephone consult with one of his minions, the upshot of which is that they were happy with the way things were going. I was not signed off, so in theory, I can phone up and get an appointment.

That's what I was told anyway. I'm OK with that as there isn't much to talk about and it would be a waste of their and my time to have an appointment just for the sake of it.

I was also told by the cardiac surgeon that if I had anything I wanted to talk to them about, I should get in touch with the surgeon's secretary to book an appointment.

My ongoing care is via my GP surgery, and I have found that having had OHS gets me an appointment pretty quickly as long as I mention it when contacting them. I have my discharge notes to refer to, which give me an idea of what I should be looking forward to and when. I fully expect to have to jog the GP's memory rather than them getting in touch when it's time to review my meds after a year.

All in all, I think the level of aftercare is acceptable, although if I had important issues that weren't being addressed, I would most likely think differently.

One last thing, I am continuing cardiac rehab, although I have to pay for level 4 rehab as my area only offers level 3 for free. Knowing that the trainer is trained in cardiac issues gives an extra layer of security and makes sure I get off my butt and actually exercise 😆

[Arfo]

Hi I am 12 weeks post stent , I have suffered with health anxiety as many do . I felt a tad abandoned though the cardio team are available on the phone . To ease my anxiety I paid for a full Mot and more extensive blood tests using a private GP service . I appreciate that I am fortunate to be able to cover the cost . However it filled the gap in the system and may be an option for some . Wishing you and everybody better health and luck in the new year .

[Lmcroy]

I have had 2 heart attacks 5 years apart two stents.

On both occasions after discharge don’t see cardiologist. I go to nurse at gp surgery and get bloods every 6 months.