Dodgy heart with a side order of health anxiety
September 1, 2019 1:36 PM   Subscribe

I had an episode of chest pain and breathlessness that landed me in hospital and that has also triggered my HA. How to deal in the interim and how to make the best of my time when I talk to doctors?

So, I've been going to the gym for over a year, doing a mix of machines and cardio. I've done pretty well - maintained slow but steady gains in fitness and a pretty healthy drop in my blood pressure. On advice from an instructor at the gym, I changed my routine to work on losing more weight (no machines, more cardio) and three sessions in, last Tuesday, I ended up in hospital and was tentatively diagnosed with something heart-related (suggestion is angina). I've got to go for a stress test and have been issued the spray under the tongue (GTN?) and some mini aspirin.
So for someone with punishing HA this is all rather difficult to deal with. I've had various heart tests previously and have been told I have an ectopic heartbeat and that there was a very slight issue with a murmur but nothing to worry about - that was about three years ago. I have other health problems that predispose me to cardiac issues (diabetes, hyperhomocysteinemia). I'm 53. I was told not to exercise by the consultant in the emergency unit, which made it all a lot more scary and immediate, and one of the other doctors present said my creatinine was up from normal levels (kidneys are a particular trigger for me as Mom had acute kidney failure before she died and dad is on dialysis at the moment).
Questions:
A) Do you have any experience of angina, either yourself or in the family? How did you / the person deal with it? What did a good outcome look like?
B) With the various other health issues I've described, and with the shocking pressure the NHS is under, I'm worried about making sure the treatment is not just cardio-facing, if that makes any sense. What takes priority in terms of my long-term health? If there is a potential conflict in treatment (for example, I didn't have steroids for an eye condition years ago because it would have made my diabetes harder to control), what should I be focussing on? A cardiologist might say one thing, a diabetic consultant might say another - what questions should I ask (politely) to ease my anxiety about what the best overall approach should be? How do I work out what's best for me and advocate for that?
I know YANMD and anything you say is not medical advice, but hearing from other people who may have been in a similar condition can be helpful.
Thanks.
posted by Martha My Dear Prudence to Health & Fitness (3 answers total) 2 users marked this as a favorite
 
First off focus on understanding what you do know which it sounds like 1) don't excercise atm 2) get the stress test 3) follow up. 4) understand the medications you've been percribed, why you have them how and when to take them.

Everything else you'll have to take as it comes. There is no practical need to think about what happens if you get two conditions together, or who should manage what or how. (Diabetes and heart issues are managed together all the time, it's very common and your doctor will know how to proceed) Right now, try and focus on the practical things you need to get through the next few days which is the above.

Health anxiety can easily take over your life, but it doesn't have to. Heart conditions are scary. But lots of people have them and they are manageable conditions .

I encourage you to write down a list of questions to ask your doctor in a notebook and order them in importance.

You're primary care doctor should be someone you trust to look over your total care (all of it) and review for conflicts and to manage things in-between specialist appointments.

For advocacy it sometimes helps to order things by symptoms that bother you most, to help make decisions if there are conflicts or drawbacks to certain treatments.

Good luck!
posted by AlexiaSky at 2:15 PM on September 1, 2019 [7 favorites]


Hi. I just had a similar thing here in Ireland under a similar and similarly burdened healthcare system. I ended up in A&E and admitted to hospital with Afib literally four hours after being in my cardiologist's office and having a clean EKG. I was on the cardiologist's list in the first place because of chest pain (unrelated to the Afib.)

Diagnostically, the path is very straight forward in terms of the successive tests to eliminate various conditions. You will get a ton of good info along the way from your stress test, echo, diagnostic imaging, etc. There is literally no part of your heart that cannot be tested, and all of my tests have been reassuringly definitive.

For me, my GP has been my best port of consultation for cross-referencing various drugs against various other conditions of middle age. I see her fairly regularly as diagnosis progresses and she's been great about additional referrals. If that is not a goer for you, you might call the British Heart Foundation's Heart Helpline: 0300 330 3311

I'm sorry I have no experience to offer regarding HA but I wonder if there's a support group for that you might find beneficial right now?
posted by DarlingBri at 2:18 PM on September 1, 2019 [2 favorites]


I work in the cardiac field. I'm not a physician and I'm not suited to give medical advice. With that being said, and with my long experience working with patients with cardiac disease, here are my thoughts:

1. Maybe you have stable angina. Maybe it's not angina at all. Rest easy and see what the stress test says and go from there. If you were unstable you would still be in the hospital. You can't know for sure if you have coronary heart disease so no use in worrying until you have evidence.

2. You were told not to exercise because there is no need to stress the heart at this time until you can get proper testing and follow up with the cardiologist to rule out angina. One of the earliest and telltale signs of angina is exercise-induced chest (neck, jaw, left arm) pain or pressure.

3. The best thing you can do for your cardiac and overall health is to keep a tight control of your diabetes and manage your blood pressure like it's your job. This means diet, exercise, and adherence to prescribed medications.

4. A "good outcome" regarding angina is remaining stable. You can research the differences between stable and unstable angina. Remaining stable may mean medical management, and perhaps if there is a need, coronary stenting.

5. If you do have coronary artery disease the treatment should be cardio-facing initially because if you at risk for heart attack this is the most pressing concern.

A cardiologist might say one thing, a diabetic consultant might say another - what questions should I ask (politely) to ease my anxiety about what the best overall approach should be? How do I work out what's best for me and advocate for that?

All would advise to lose weight, manage blood sugars and blood pressure. A cardiologist is concerned with preventing heart attack, opening blockages (if present), and preserving heart function. I don't think there will be much contradiction with specialists who manage your diabetes and heart. Cardiologists deal with patients with diabetes (insulin and non-insulin dependent on the regular. Some heart meds can affect blood sugar. I can't think of any that overwhelmingly do so. Cross that bridge if and when you get to it.

Once you get the clear to exercise --keep exercising moderately and regularly. It is the very best medicine and is more effective than any drug as far as prevention goes.

One day at at time and remember you don't know for sure if you have cardiac disease yet. It could be something else entirely (GERD, muscle-skeletal) and if you do have CAD that causes angina, it is manageable. Good luck and good health.
posted by loveandhappiness at 9:46 PM on September 1, 2019 [5 favorites]


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