To take DS to A&E today

[VoldemortsNipple]

A bit of background. DS (16) has been having dizzy spells for a while now and they seem to be getting worse. He will become dizzy, his breathing becomes laboured and he gets chest pains. If I'm honest, it looks like a panic attack. However DS is naturally not a worrier and they don't seem to be brought on by anxiety. We have been going to the GP to get to the bottom of it since the beginning of the year. I cant fault the GP as she's been brilliant.

DS went for an ecg back in March, which showed a slight problem? We were told it was probably nothing and just down to DSs build. As a precaution the GP asked for a second opinion from the cardiologist. Next thing we know, DS had to have an echocardiogram. I really wasn't worried at this point, I just thought they wanted to rule things out.

When we went back for the results GP said the echo identified that DS's heart muscles were weak. She had spoken to a cardiologist who recommended an MRI scan. She also told DS to take it easy and don't take part in vigorous exercise.

So when we turned up for our appointment which we thought was for an MRI, we find out we were just there to see a Cardiologist. He asked us for a brief history and decided that he wanted to start again from the beginning as from what results he could see, he didn't think DS had a heart condition but did think it needed investigating. He told DS he could exercise and to carry on like normal. He sent him home with a portable heart machine on to record any symptoms. That was 4 weeks ago and we haven't heard anything back.

So for the past week DS has been at a cadet camp. The camp was for higher level cadets and was physically tough. DS took a letter with him from myself explaining that he was undergoing tests but was okay to carry on as normal. During the week, DS has had at least ten attacks, which is way more than normal. Twice the instructions took his to hospital because he was taking a long time to recover. The hospital were happy to let him return to camp as DS was determined to carry on and finish the course. On the way home yesterday, DS had another attack on the minibus and he momentarily blacked out.

He is supposed to be going on another cadet trip in a weeks time for ten days. I can't get an appointment with his GP next week and we still haven't heard from the last hospital appointment. So do you think it would be unreasonable to take him to A&E and see if we can get some answers? I'm not convinced that he doesn't have a heart condition. The Echo results obviously showed there was something going on and the NHS website says panic attack type symptoms can manifest in some heart conditions. I really need some peace of mind before sending him off to another camp.

Sorry for the long post, I didn't want to drip feed.

Cancel the next camp, & take him to GP when you get an appt. I know it's a disappointment, but even if you take him to A&E, he could be advised to skip next camp.

A&E is for situations which are life-threatening or where immediate care is required to prevent bigger problems, this is not like that.

holidays I meant the portable machine ecg where they wear them overnight not the ones you have in the hospital. Obviously they ones in hospital spit out paper there and then, the portable units need data reading and it takes ages to get results back from India. Have had this verified from 3 separate nurses and the heart consultant, pretty sure they weren't colluding to spin me twaddle

My 19 yo dn has been diagnosed with supra ventricular tachycardia.Took us a while to get the doctor to refer her but it was diagnosed after wearing the heart monitor.The symptoms sound similar to your ds.I am rubbish at links but you will find info on NHS website.It is treatable and not life limiting,very scary though when they have an attack.As poster above said call the cardio on Monday.Bending over and getting up too fast triggered dn attacks.

Unless he is having symptoms ie a blackout now then A&E will be of little use and I agree with pp that you need to ring the secretary on Monday - and no more cadets until it's sorted - frankly I'm amazed that they didn't send him home earlier in the week having taken him to hospital twice and I'd be concerned that the leaders of the camp are taking such risks with his health .

If my child was blacking out after being told he had a heart condition I would consider that life threatening at that particular time.

Verbena37 but he isn't.

A&E is for situations which are life-threatening or where immediate care is required to prevent bigger problems, this is not like that.

Yeoldtrout not sure it's a good idea to be diagnosing the OP's child...he had the same symptoms yesterday and blacked out.....of course if he has them again, she should take him to A & E. Obviously if he is symptomless, there isn't much point but if they occur again, she absolutely should take him to A & E or if it gets really bad call an ambulance.

It's not like he's got a cold or got a splinter; he has been having tests on his heart and they've said he has weak heart muscles.

Is reiterate what PPs have said: no more strenuous activity and phone cardiology sec on Monday. A&E won be able to help you today, and would be a waste of both your and their time.
Also, ECGs being read in India?! Seriously?! I wonder what I've been interpreting all these years then...

Is he unwell today? If not, what are you expecting from the a&e doctors?

In your position, unless he is becoming significantly worse over this weekend, I would be ringing the cardiologist's secretary first thing monday morning to explain he has had more symptoms and chase up his next appointment. Cadet camp would also be off the agenda until you had some answers.

Very worrying for you though I would be reassured that noone is leaping about as if it is a major emergency.

If he's having symptoms right now, then a rhythm strip in A&E could indeed be useful. If he isn't... is it settling back down to normal for him now he isn't doing the high impact activity? If not, either ooh (who hopefully will have access to gp records - many areas do) or A&E. Is he getting back to normal self in between episodes, as if not A&E. From your description, I get the impression that the cardiologist thinks the muscles of the heart are working okay, but doesn't want to miss any chance these episodes are down to occasional blips in the electrical signals controlling the rhythm. He'd have wanted normal activity whilst on the Holter monitor, in order to see what was happening. I do wonder, though, if the cardiologist's definition of normal activity and your son's are a bit different...

In summary: I would suggest if actively symptomatic (especially worse or longer than usual), not normal between episodes, or rate of episodes not settling, worth being seen. If back to his usual state, secretary on Monday. But ultimately you're the one there.

Just bear in mind A&E can check nothing's newly gone drastically wrong, which may be what you're after, but they won't have all the old results, and although docs will be there, the non medics for a lot of the fancier long term tests won't be. So odds of finding out the long term answer rather low.

They're sending the Holter data to India??? I'm allegedly in a failing trust, and even we can get them interpreted locally, faster than that. Or maybe that's why we're failing: putting service ahead of saving pennies.

Just to add, my SVT can be triggered by all sorts of things but caffeine drinks, nicotine, strenuous activity, tiredness with dehydration are all risky.

There's a good free app called heart rate monitor. I use this to track my heart rate and it allows me to tag what I was doing at the time. I use this with consultant & GP to objectively show how many attacks I have and recovery time.

After I have tachycardic episodes my blood pressure falls and I get dizzy and nauseous. Not I'm not saying this is what your son has, but I find lying down on left hand side and drinking large glass cold water with regular breathing helps me.

Makes those calls and good luck

Didn't realise anyone was diagnosing.

A&E is for immediate threats to life, limb or sight.

Why would OP phone for an ambulance now when nobody rang for one last week when he had chronic blackouts? May as well take him in herself like they did last week. EMTs are not going to have miracle powers of diagnosis or treatment.

I don't think this is an A&E situation. I would be on the phone to the consutlant's secretary come Monday morning.

He wouldn't be going on the next cadets camp either. It's not fair on him, they're obviously making him ill, and it's not fair on the staff who have to take the time out to take him to hospital etc.

chiuri why do you take over 3 months then?

He needs to follow the instructions of the medical staff - no strenuous exercise. It would appear from the history that this was ignored at camp - I have to be honest, I would have pulled him from the first camp following the first hospital visit, he was clearly not being responsible for his own health and neither were his instructors.

Unless he is in acute difficulty, A&E will not be able to help him, you will end up following the same referral path as your GP anyway, and this will not be accelerated. Of course, if he is in acute difficulty, A&E is absolutely the right place, and he will be investigated urgently.

Right now, email the cardiology clinic and advise of the changes that he has experienced, follow up with a call on Monday. You could ask to be notified of any cancellation to see if you can be fitted in earlier - in my experience, there tends to be a lot in cardiology as conditions fluctuate. Also, I think you need to be a bit stricter with your son about the consequences of over-exertion. It is rubbish for him, but at 16, he's old enough to understand and take some responsibility for his health.

Debs when I wrote my reply I missed the correction of the initial post, saying it was holter monitors rather than plain ECGs. I can and do interpret standard ECGs, but am not personally involved with holter monitor interpretation. But I refuse to believe that such a ludicrously inefficient method of interpretation is used anywhere in the NHS! For non-urgent, outpatient holter monitors the delay in results being available is likely due to the multi-step process of sitting in a large pile of these non-urgent investigations for interpretation by understaffed and overworked departments, transferral of the results through antiquated means due to the lack of joined up care (ie snail mail rather than using a single server database) and then your understaffed and overworked GP finally getting a look at them and contacting the patient.
Slightly less delay through hospital referrals, and urgent or inpatient investigations can be reviewed MUCH quicker as necessary.

Thanks for all the replies.

DS got home an hour ago and has gone to bed. (He slept at my sisters last night as they arrived back very late and she picked him up for me as I don't drive)

Thank you for putting things into perspective for me and making me realise spending the day in A&E might not get us anywhere. I'll try and get an emergency appointment at the doctors on Monday morning and see if they can speed things up with the cardiologist. If not I'll ring them directly.

Although if he has any more episodes I will probably take him to A&E because I need some peace of mind.

plecofjustice we were following medical advice. The GP said no strenuous activity. But at the appointment with the cardiologist, he countered that and told DS to carry on as if he didn't have a heart condition. So this is the advice he followed as this was the most recent advice.

DS has said that he had 3 attacks in one day, they usually last a couple of minutes and he feels fine afterwards. The last one lasted 10 minutes. The hospital was right next door to the camp so it was quicker to put him in the back of a truck and drive him themselves.

OP, I'm glad your DS is feeling better and getting some rest. It must be very stressful for both of you.
Your cardiologist will almost certainly want to know about this escalation of symptoms, so you're doing the right thing getting in touch with him via your GP ASAP. Medicine is often more of an art than a science, and although your consultant was drawing on the presented information and, I'm sure, his years of experience when he gave you the advice to carry on as if he didn't have a heart condition, it's fairly clear now that that's not necessarily the case. The good thing is that it is more information for your cardiologist to draw on. See it as another piece of the puzzle rather than a set back.

Voldemort I would ring the secretary yourself on Monday morning, as well as getting your GP on the case.

Its just so horrible when they are hundreds of miles away and you feel so powerless. DS is so laid back about the whole thing and pulls that "stop being so dramatic" face at me when I start asking questions. In all fairness, I'm pretty laid back myself, but the increase of the attacks just doesn't sit well with me this time.

DS is convinced he is fine to go to the next camp so I'm playing it down at the minute until we can see a GP and then I can ask their advice. I don't want him to be having more symptoms over the weekend and not telling me incase I say say he can't go iyswim.

How worrying. Definitely I'd err on the side of the first advice of no strenuous activity and definitely not let him go to the next cadet camp.

Really push, as others have said, for cardiology to get moving with this. Ask to speak to consultants secretary on Monday, tell them his symptoms are becoming more frequent, what's been going on, and that he has had frequent attacks when exercising and that he needs further assessment and investigation to work out what's causing this and how best to control it.

Good luck. Be firm and don't be fobbed off.

Have to agree that a) this isn't an a&e issue and b) he shouldn't be going on another trip until it's all sorted.

Hope you are about to get a resolution soon though.

I would read up about SADS ( sudden adult death syndrome)
Demand 2 nd opinion from cardiology and also insist on urgent appointment at GPs
You don't want to alarm your son but you can't neglect these symptoms
Good luck

My cousin aged 30 died from SADS with no warning, no symptoms previously.

I would call the cardiologists secretary on Monday morning.