To go to a & e?

[dontrunwithscissors]

I've had heart palpitations over the last few weeks and numerous ECGs. They've all been OK, but I was not having palpitations at the time. I take a medication (quetiapine) the can cause heart problems. My brother died of long QT syndrome (heart arythmia). I've been told things seem OK. Over the last few days, I've had chest pain and feeling breathless. I now have tingling down my left arm. I thought it might be anxiety so took diazepam, but it hasn't helped really.

I'm currently away at a conference in Notthingham (from Scotland). WIBU to abandons the conference and take myself to a and e here/now, or wait until I can see a doctor at home on Monday?

Or do they still have NHS 24 in England?

The only way to get an ecg while you are having palpitations is to go to A&E while you're having them (or call an ambulance) or have a 7-day mobile ecg in the hope that will pick some up. Pointless going to A&E if you're not suffering any symptoms.

Argh, too late. Back in the city centre/hotel. The symptoms have really died down again. . This keeps happening--seems pointless to keep going getting ECGs when the symptoms are not there. They just seem to compound the opinion that it's 'all in my head.' I'm pretty darned sure it's not. I'm not an anxious person at all and know when if I am feeling anxious. I feel that having a psychiatric diagnosis means that physical complaints are often put down as signs of depression or anxiety, which would not be the case other wise.

I'm going to have a lie down and see how I feel. I don't want to feed the 'take a diazepam' brigade by getting and ECG when I'm not symptomatic.

Why would you be on a drug that cab prolong your QT with your family history? I think that needs querying

Because it keeps me mentally well. I've had quite a few ECGs and my QT interval has always been fine. I've worked my way through a lot of meds. In fairness, my psychiatrist has referred me to cardiology for a second opinion but my appointment isn't until mid November.

I think November is too late to query this. Quetiapine can cause Long QT without family history can't it? It's important to have medication that keeps you well but also important not to die from arrhythmia etc. I think this should be chased and reviewed urgently with the symptoms you've described.

Sorry, should have added.....but, yes, it is concerning. In addition to my brother dying, my Dad has long QT, and my great grandmother died suddenly in her sleep in her late 30s (which is what happened to my brother), although we don't know for sure whether she had it as that was many years ago. My dad witnessed his 10 year old cousin drop dead in front of him when they were playing. Suffice to say there's a strong history of sudden death/long QT in the family.

Nevertheless, I don't think I stand to gain much by traipsing to A and E right now.

When my mum had strange palpitations at random times, she was given a monitor to where for something like 48 hours. It may have been longer. It meant that there was more chance to catch the oddities.

X post leghoul~~I don't know. I'm confused on this whole issue. Im due to fly to the U.S. next week for 3.5 weeks so can't bring it forward.

Yes, quetiapine can cause long QT in the absence of family history. However, I'm also told that it can cause harmless cardiac symptoms and that the fact my QT interval has been fine means they're not too worried. This all started back in Easter when my pulse was randomly soaring to 100bpm (at its worst it was 130bpm) for ten minutes and then stopping. That went away when I reduced the quetiapine dose.

The last few weeks things have been getting worse and I'm v confused at what I should be doing about it.

Sorry, another cross post soupdragon. I've been told they will do a 24 hour monitoring, but it will likely be near Xmas before that will be done.

Sorry! I meant my pulse was randomly going fast and then slowing back down---not actually stopping!

drugs to avoid

many people don't have symptoms

nice blog on it

difficult if you are going away - you need 24 hr ECG monitoring at least. Don't increase your quetiapine. Try and be seen before going away.

I had all these symptoms and it turned out I was in a high state of anxiety.

I have anxiety, so I knew what it felt like but that episode felt nothing at all like anxiety. Apparently it was anxiety where the person doesn't realise they are anxious

I would still prob go to A&E. Just to get checked over again.

I was like this a few weeks ago and went to A&E. The Doc checked me out, told me I was too young for heart problems (I'm 30) and sent me on my way. Got checked out by my GP and it was some weird virus that turned into a chest infection! Not nice but much better than the alternative!

I think you should go to A and E too

Do go and get checked out. I was on quetiapine and having symptoms like yours and an ECG showed QT Prolongation. I had to stop the quetiapine immediately which was a real shame as it kept me very well. I have no family history.

I hope you are feeling better. Not being medical myself I would err on the side of caution and honestly, I hate 'making a fuss'.

The worst of the pain had stopped when I got back to the hotel. I had a little nap and felt better when I woke up so haven't been to a & e. I have an ECG booked on Monday morning and will make an appointment with a GP for the same day.

Make sure you declare your pending medical investigations to your travel insurer before you go to the US. You do not want them to refuse a claim on US medical bills if you are taken ill over there - treatment can quickly run into tens or hundreds of thousands of dollars. Likewise, medical repatriation can cost tens of thousands. A word of caution though: DH had seen the GP about something, got a referral letter for our local private hospital (covered by his company's health policy) and didn't get round to booking an appointment because his symptoms settled. When I renewed our annual policy a month before a big holiday, they excluded any problems relating to the affected organ from our annual travel cover. Even after he'd seen the consultant, had lots of investigations and the all clear in the month before we travelled & DH had a copy of the letter to his GP saying this, they wouldn't remove the exclusion and and only took it off when we renewed this year.

Thanks romcom. I'm going to the U.S. for work and so have everything covered by work insurance.

Have you google tietzes disease?
It does a spectacular job of masquerading as a heart problem.
Mine is much more painful if I am cold/stressed

Never heard of that. Will google. Typically, it's really settled down. I guess I would probably be BU to push my quetiapine dose up tonight in the hope I have the palpitations when they do the ECG. I'm fed up of messing around.

Seconding ah on Tietzes - look up costochondritis too. Very similar to Tietzes but doesn't show up on tests.