Should I go back to A&E?

[DoesitneedaGP]

Have been having episodes of palpitations that GP and cardiologist are 99% sure are stress induced and nothing more .

had an ECG last week at cardiology and then another, and a 24 hour monitor - one of the ECGs they said had something discharged with a 24 hour monitor, I ended up having a bad episode that night and was sent by 111 to A&E . They did another ECG which was fine .

had a funny episode tonight, very anxious and disoriented and derealised then heart suddenly felt like it went ‘funny’, felt like I was going to pass out for 30 seconds - everything went all funny and distant - then stopped and ‘normal’ . Rang 999 as was so panicked I was going to black out . They said it’s not for them and to go online to nhs inform, ring GP or 111 .

this has happened a few times in the last two years and it’s always been explained as panic attacks . I’ve never had an episode that’s actually been caught on an ecg .

im terrified of it being heart problems that will kill me suddenly - my family have all had heart disease -one with a condition that’s inheritable that causes sudden death, the rest just coronary disease but I’m panicked. I’m in the house alone and not sure what to do .

For what you've written sound anxiety induced. Perhaps books another GP appointment, see if you can have another 24hr ECG to put your mind at rest.

For the potential hereditary conditions, is it an immediate family member, and are there tests that can be done to determine whether you are a carrier? If so, I would post for those, although I appreciate that's not the easiest given the way GP surgeries tend to be at the moment.

For tonight, I'm not sure A&E is the right answer. Try 111 if you feel you need to be seen.

It’s a panic attack- ecg will be fine. I had one when my anxiety started and they said it skipped a beat then next one was normal. Please order book called panicking about panic - on Amazon- it will all make sense trust me

Is it worth asking for a referral for therapy for health anxiety? I know that might not help reassure you tonight but might be useful going forwards?

I had terribly frightening palpitations and realised it was linked to peri menopause, they have completely stopped now I am taking HRT.

Second degree I think they said (parent’s sibling) . Cardiology’s recommendation is to get an ECHO and 24 hour monitor every 3-5 years, this is year four since I was last given an echo and got stress test then tooo which was also normal . Family member had genetic testing which came back with nothing so they’re not sure if it could definitely be passed down or if it was a spontaneous thing . A&E said last week reviewing cardiology notes that my cardiologist (who I’ve only spoke on the phone with once) isn’t overt concerned at all unless tests come back funny, just to keep up with screening .

Hiya!

I'm so sorry you're going through this - I have bouts of it myself. Sometimes it's anxiety, but sometimes it's if my estrogen dips as I'm sensitive to the fluctuations.

I also suffer from dumping syndrome as I've had major abdominal surgery - do you have any gut issues? Do these episodes happen after you've ate? Palpitations are common with this for me, too.

It could be worth tracking them, ie when the occur and where in your cycle you are, as well as if they occur after certain foods.

Magnesium really helped me but I do still get them from time to time.

Please try not to worry as much, you've had a monitor on for 24 hours and nothing was found - my palps were actually caught on an ecg and still were no big deal and signed off by the cardiologist.

OK, managed to get through to 111 who said based on symptoms to go to A&E for another ECG but I’m less than sure … A&E will be at the very least a five-six hour wait if not longer - for I’m guessing exactly the same tests as last week, bloods and an ECG and then waiting five hours to see a doctor . It’s settled a bit now . I’m wondering about giving it half an hour or so and seeing if it settles down . I’m 99% convinced it’s anxiety, I was anxious before it happened - was feeling increasingly strange/depersonalised before it happened and they said last week it is just anxiety/panic attacks .

I am having a period at the moment so could easily be hormonal yeah, I’m on to day 14 of my period (on the mini pill and have PCOS so longer bleeds normal for me unfortunately) .

It's not an accident or emergency, so A&E is completely inappropriate.

Please ask for a 7 or 14 day monitor - a 24 hour one can be a waste of time, unless your heart plays up in that particular 24 hour period.

I take instant heart readings with my Apple watch, that gives me more than good enough readings to email to my consultant.

I know they come at a cost but worth every penny for peace of mind if it’s affordable of course.

a Kardia heart monitoring device is also worth checking out.

I wish you all the best, heart stuff can be so very worrying I know.

Sorry you feel like this op. Health anxiety can be scary. Are you taking anything for your anxiety. Could it be worth speaking to your Dr about beta blockers to help quickly calm you when you have these anxious moments. I went through a few months of health anxiety and was prescribed beta blockers to take as and when needed, which helped.

Try not to Google symptoms either, it doesn't help. Try and distract yourself as much as possible. You tube was my go to.

I dont think it warrants an a and e vist. Just book a gp appointment tomorrow and like someone else mentioned track symptoms to see if there are patterns or triggers.

I’ve got propranolol yes, I’m not always very good at remembering to take it and then I’m too scared
to take it in case I accidentally OD - need to get a pill box .

I’ve rang 111 back to ?the A&E advice as really not sure that it’s going to help going over there for another six hours . This has happened before - exact same symptoms - and each time they’ve done a 12 lead,
troponin bloods and then sent home saying all OK.

its ARVC relative has which is supposedly difficult to catch but I’ve had well i excess of 50 ECGs in the last 10-15 years and never had anything come back, just benign PVCs .

These sort of episodes didn’t start until 2020 though, it’s a sudden (ish), I could feel myself getting more and more het up on phone earlier and dissociating a bit, which tends to make me panic anyway as it’s such a strange/disorientating feeling .

Is there an OOH GP service that 111 can refer you to?

That’s what I’m asking them to do yeah, see if a GP can ring me instead .

It’s gone through as a ‘disputed outcome’ which means a doctor will ring me instead . Nurse said she’s 95% convinced it’s anxiety too but said symptoms mean they have to refer to A&E each time .

Have you tried therapy?

I have on and off yeah, consultant said she was going to try and refer me again, I’ve had involvement from mental health since I was 16ish . They always say stuff about challenging your thoughts/‘taking them to court’ which I suppose it’s kind of what I’m doing just now on some ways .

In other ways I’m lying in bed thinking, ‘what if there IS something wrong and I’ve not gone to A&E so won’t know’ but hopefully someone rings soon . The A&E consultant last week said she genuinely thought it was all anxiety related .

GP rang, ECGs last week were all very normal so she said she’s happy for me to stay at home . Said that it is just panic in her opinion . I’ve been getting more and more stressed all day and then started with the dissociation on the phone to my sister which is a horrible, horrible feeling and usually does trigger panic .

DH has palpitations and anxiety. He found that lying down and taking deep breaths helped. And also making sure he doesn’t get dehydrated in hot weather (not drinking too much, just making sure he has enough). We think he might have some similar symptoms to POTS - though no formal diagnosis.