Upsetting visit to A&E chest pain bradycardia - Thyroid UK

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Upsetting visit to A&E chest pain bradycardia

pj16 profile image
pj16
24 Replies

Hi all. First a piece of good news. One of my daughters finally got a diagnosis of Hashimoto’s and was prescribed Levothyroxine last week.

That’s as far as the good news goes regarding doctors.

For over a week when I lie down in the evenings I develop chest pain, nausea, tingling hands/feet etc. By this point my heart rate is usually high 40’s or low 50’s. Last night it was particularly scary so this morning I phoned NHS 111. Long story short. They sent an ambulance, I stayed in A&E all day to finally see a doctor who made me feel like I had wasted everyone’s time. I feel so upset. He basically said it’s not possible for a low heart rate to cause chest pains. He said my heart rate of high 40’s proved I was fit and healthy and it was normal. He said that even if it was 30 it would be normal. He questioned why I had my own pulse oximeter. Then came the comment I was dreading. You’re probably getting chest pain and tingling etc because you’re anxious about your heart rate. He also said I needed to take a statin as my cholesterol is getting higher even with all of the changes I’ve made. He also said I definitely don’t have a thyroid problem. So I guess when I’m in pain later and afraid to go to sleep I’ll just have to try to ignore it! I’m sorry for the rant but I’m feeling a combination of imposter syndrome, rage and upset. If you made it to the end thanks for reading. 💐

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pj16
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24 Replies
Jaydee1507 profile image
Jaydee1507Administrator

Honestly, he likely didn't have the training to comment on a fraction of what he did. I'm so sorry that you have been spoken to this way. So very unproductive and upsetting.

Where are you at now with thyroid treatment and what were your latest labs? We should really check that out for you and make sure you're on optimal treatment.

Talking of optimal, the other things we need optimal are our vitamin levels? Are you supplementing anything, if so with what and what were your latest blood results for ferritin, folate, B12 & D3?

With heart rates that low it looks like you are under replaced.

pj16 profile image
pj16 in reply toJaydee1507

Hi Jaydee1507

I so much appreciate your quick response thank you 🙏. My TSH at it’s highest was only 4.51 (felt awful) and I only had raised TG antibodies (about 450) and not TPO. No-one offered me a diagnosis with those results. In order to try to get my life back and based on a lot of great help and advice from this site I went gluten free, had my vitamin levels tested (all were low) and supplemented. Because of this my thyroid results and vitamin levels improved. The changes to my gastrointestinal symptoms were a huge bonus! I have plenty of other symptoms which still chop and change, come and go. I still suspect I might have Sjogren’s too. This year I decided that maybe I didn’t need the supplements any more so stopped taking them in March. My GP thyroid test in March seemed good enough too (I’ll look those up and post later). Maybe I need to re test everything and start over. I’m desperate to reduce my cholesterol but don’t want to take a statin if there’s a chance I have Hashimoto’s. It’s all so frustrating. Thank you again. 😊

Jaydee1507 profile image
Jaydee1507Administrator in reply topj16

Raised cholesterol is often due to low thyroid levels and a heart rate in the 40's isn't healthy unless you're an athlete which I suspect you aren't.

Its probably time you retested all your levels, thyroid and vitamins privately so you can see where your FT4 & FT3 are at.

With even one type of antibody positive you do have Hashimoto's. It can wax and wane a lot sometimes for years so it would pay you to keep an eye on it every 4 months or so.

pj16 profile image
pj16 in reply toJaydee1507

Definitely NOT an athlete. I do go out for a daily walk and try to climb 10 flights of stairs a day. I’ve just remembered the doctor also said two more questionable things. Apparently my blood pressure of 89/58 is ‘very healthy’. When I asked about the possibility of a degree of autonomic dysfunction causing my symptoms that was a no too. Apparently if I had autonomic dysfunction my low heart rate would stay low even if I stood up and went for a walk. I’m not entirely sure if either of these statements are true but I’ll certainly be checking!

Jaydee1507 profile image
Jaydee1507Administrator in reply topj16

There are very few doctors who know about and understand autonomic dysfunction. I can say this with certainty as I have it myself and have experienced much ignorance and misunderstanding. The only doctors I have found that do 'get it' are the very few who are specialising in that area.

I would suspect that low thyroid levels may be causing your low heart rate. Low BP can be autonomic, see POTS UK website for doctors specialising in this area.

Lauradietrich101 profile image
Lauradietrich101 in reply toJaydee1507

Jaydee1507,

If your heart rate is going that low, there is something wrong. I don’t know if it is thyroid or not but you need to find a good cardiologist before you decide to ignore it. I will keep you in my prayers BUT please find a cardiologist immediately!

bantam12 profile image
bantam12

A pulse oximeter can’t be relied on to give an accurate reading,

I have a pacemaker set to not go below 60 yet my meter frequently reads in the 50s which is just not possible. Both my pacing tech and cardiologist said they often don’t pick up beats.

pj16 profile image
pj16 in reply tobantam12

Hi bantam12

Thanks for your reply. I agree that they can’t be entirely relied upon. If my Fitbit and/or pulse oximeter read less than 50 I then take a manual reading.

SlowDragon profile image
SlowDragonAdministrator

Suggest you get FULL thyroid and vitamin testing done

Important to maintain GOOD vitamin levels……likely levels may have dropped if stopped supplements

all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(But Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/getting-a-dia...

High cholesterol is strongly linked to being hypothyroid

pj16 profile image
pj16 in reply toSlowDragon

Hi SlowDragon!

Thank you. I’ll definitely get all tests redone. I’m so conflicted about how to tackle my high cholesterol. I genuinely cannot live a more healthy lifestyle than I already do. All the while I’m worried that my high cholesterol is worsening my coronary artery disease. Since December I’ve even given up ALL alcohol. 🌸

greygoose profile image
greygoose in reply topj16

Have you done any research into cholesterol? It really isn't going to make your coronary artery disease worse. But your coronary artery disease is possible the cause of your high cholesterol - one of them, anyway.

When the areteries are damaged, cholesterol levels increase so that it can act as a sticking plaster while your arteries heal.

High cholesterol is not the problem doctors make it out to be - they just get their info from Big Pharma sales reps who want to sell statins! It doesn't cause heart attacks or strokes. It is a necessary element of your body. Your cell walls are made of cholesterol, as is a large part of your brain. And sex hormones are made from it, too. High cholesterol is a symptom, not a disease.

And, it has next to nothing to do with your life-style. Cholesterol is made in the liver, and the liver does its best to keep the level steady. So, the more you consume with your food, the less it makes. And, vice versa. So, please don't worry about it - and don't take statins - your cholesterol is doing its job and you're more likely to have a heart attack with low levels than with high. :)

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator in reply topj16

Suggest you read The Great Cholesterol Con by Malcolm Kendrick

Cholesterol levels will drop as your Ft3 (and Ft4) increase, once you get started on levothyroxine

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

ICE187 profile image
ICE187

I was already hypothyroid for 7 years according to my blood results, but it was ignored. I was put on statins. I monitored my cholesterol which got worse while on statins. I quit taking them against my doctors orders. My cholesterol numbers dropped some once I quit statins. When I was finally diagnosed with hypothyroidism and put on Levothyroxine, my cholesterol numbers started dropping faster. In 6 months time after adjusting my Levo, my cholesterol dropped over 100 points.

Staffsgirl profile image
Staffsgirl

Would also recommend The Great Cholesterol Myth by Boden and Sinatra.

Sexyfish profile image
Sexyfish

This can actually be very serious. I’m really sorry you were seen by an ignoramous. However, what you’re describing could also be something like pericarditis. And yes, that is very much heart related. If you have pain, go back. They need to do an ECG at the least and take your troponin levels. Just make sure you make a song and dance and throw things like pericarditis at them.

Confused01 profile image
Confused01

Hi there,

Sounds like you was unfortunate to get such an uncaring Dr and his opinion is wrong. Have a Google about Bradycardia. 40 is low, 30 is very low.

I have Bradycardia and I get on/off chest pain, not extreme, but I recognise it.

Ideally you should be considered for an Echocardiogram and a 7 day holter. That will give you good heart testing.

Maybe talk to your gp . Mine said lots of people have Bradycardia and means nothing..true, but should be checked if symptoms of tightness etc are accompanying it. That’s what my Consultant said.

x

arTistapple profile image
arTistapple

I can hardly answer this (it’s pretty much my story). I agree wholeheartedly with Jaydee1507 . I have been dealing with this problem for over twenty five years, some incidents worse than others. I will communicate with you when I can. It’s just shocking that this is still happening to patients even although I have recent experience and the doctors remain pig ignorant. It makes me very very angry.

humanbean profile image
humanbean

I've never had bradycardia myself so have little info on it. (I get tachycardia.) But I thought this was quite a useful summary :

bestpractice.bmj.com/topics...

I also quite liked this link :

patient.info/heart-health/p...

I think you need to see or speak to a GP. The doctor in A&E who said even a heart rate of 30 is normal is probably killing his patients off while thinking they are athletes. He is/was an idiot.

You say you are not an athlete - but your level of exercise is quite high compared to many people. I still think your heart rate is ridiculously low. If you had a gadget to monitor and keep records of your heart rate you might do better in persuading doctors to test you for various problems. With any medical problem, having visible evidence is always helpful.

I think you need to get a 7-day monitor and shouldn't allow yourself to be fobbed off. Take a witness with you to doctor appointments - preferably an adult male who will back you up.

If you are forced to speak to a doctor on the phone (rather than see them) put them on speakerphone/loudspeaker if you can, get your male witness to introduce themselves (very briefly) to the doctor so they know you have a witness, and then get the witness to take part in the phone call (just by confirming the problems you are having), to back you up.

Also, in any situation when you meet or talk to a doctor you could record the appointment. Whether you tell them you are recording is up to you, but I don't think you have to.

It's a shame you don't have a recording of the idiot in A&E.

...

The fact that you have bradycardia AND have hypotension (low blood pressure) together makes your situation potentially even more dangerous, although your hypotension is not severe.

A systolic blood pressure of less than 90 millimeters of mercury (mmHg) or diastolic of less than 60 mmHg is generally considered to be hypotension.

...

However, in practice, blood pressure is considered too low only if noticeable symptoms are present.

...

I wonder if you have problems with your electrolytes?

High levels of magnesium can cause bradycardia. And high levels of sodium can cause hypotension (which surprises me given we are encouraged to reduce salt to reduce our blood pressure!)

Thinking of other possibilities...

There are a lot of possible causes of chest pain in this link, although your bradycardia and hypotension will eliminate many as possibilities :

en.wikipedia.org/wiki/Chest...

Singwell profile image
Singwell

What?? That's appalling. HR in 40s is not 'normal' nor a sign of fitness. Did they take you bloods in order to inform you you've no thyroid problem? As for the anxiety nonsense.. There is something you might look into though - link between lying down, chest pains and hiatus hernia or bad heartburn. Have look first at the British Hernia Society website under hiatus hernia, then go to the York Cardiologist YouTube channel and search for hiatus hernia and acid reflux.

Batty1 profile image
Batty1

When my HR drops below 60 for me I get extremely anxious when my HR goes up to low 70s my anxiousness goes away. That Doctor is wrong.

pj16 profile image
pj16

Thank you all so, so much for your responses. I’m currently heading out for a gynae appointment (post meno bleeding 🫤) but will send a more detailed response later. As a quick aside, on reflection I’m not sure the person I saw was even a doctor. He was wearing a green uniform?

humanbean profile image
humanbean in reply topj16

on reflection I’m not sure the person I saw was even a doctor. He was wearing a green uniform?

I couldn't find a page showing the uniform colours and designs used by the whole NHS. It seems that different hospitals might have their own designs and colours.

I remember being in hospital and asking what the nurse colours meant and as a rule of thumb the darker the uniform is the more senior the nurse.

But doctors aren't necessarily the same, and therapists, technicians, housekeeping etc might have colours and designs that are completely different from those nurses and doctors wear.

If you google the hospital you were at and ask "Meaning of uniform colours at hospital X" you might find something helpful.

I found these for Leicester hospitals :

leicestershospitals.nhs.uk/...

and this one for Barnsley hospitals :

barnsleyhospital.nhs.uk/vis...

pj16 profile image
pj16 in reply tohumanbean

In fairness to him, he might have been a consultant cardiologist wearing scrubs! On the other hand he didn’t introduce himself and had no name badge so 🤷‍♀️.

am111 profile image
am111

Some of your symptoms suggest that you could be B12 deficient. You should test it, but if you have been taking any supplements, you can get a false high result.

Resting heart rate should be 60+, ideally, around 70. Low 50's is not too bad, but suggestive of low thyroid levels. I sometimes get it around 55 or so, with no symptoms. Get a full panel thyroid test. Also, whenever you find abnormal heart rate with any kind of machine, do try to test manually too, as these machines can be inaccurate. Another test is to see if the heart rate changes between inhalation and exhalation. If it does (mine can almost stop on exhalation), then it is a good sign.

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