Angiogram shows Atheroma + vhigh cholesterol and bp but back to work?

[ARoomSomewhere]

H had chest pains radiating to jaw 2 yrs ago (age 50). Paramedics did scan and sent him to (awful small local country) hospital.
They kept him in an hour, did no bloods/tests, and sent him home in a cab as he 'seemed better'.
He's had chest niggles on and off but badly again lately and I insisted he went back to GP. His cholesterol tested at 8.6 so they sent him for some further assesments (same hosp). He was signed off work meantime (bus driver). 3 weeks later the last result is in:
CT scan is: not entirely typical of angina and did well on treadmill test but Angiogram shows some Atheroma (roughening of arteries). combined with his cholesterol and bp we should deal with this in an aggressive manner by increasing statins still further and prescribing daily aspirin. His immediate blood relatives must also be checked. The roughening is not causing his symptoms but his bp and chol must be well controlled.'
The GP says he can 'return to work tomorrow' and that the kids dont need checked as they are (nearly 11 and 14).
Obvs he cannot be signed off forever but I am concerned that they are sending him back when he still has significant chest pains and shortness of breath? even if it is partly panic attacks (he is an anxious person) surely they need to work out why he's having them?

anyone?

bumping

At the very least I would question whether he is insured to work as a bus driver with continuing chest pains and shortness of breath. Is his BP under control now?

He wasnt given his bp results as far as i know.
I do think they should be looking at the source of the chest pains before he returns. Presumably GP's will only sign off for a set period?

I agree, knowing what's causing the symptoms is very important.

To look at things very simplistically, either the GP hasn't shared enough detail with him and he is in fact fit to return to work. Or, the GP still doesn't know what's going on but has suggested a return to work regardless. I hope it's the former!

Either way if he's still symptomatic he should seek further medical attention. I'd also want to chase up what I assume was query familial hypercholesterolaemia due to the mention of reviewing first degree relatives.

What does your husband think about it all?

I agree that it is a concern that he is a bus driver and he is sent back to work and doesn't seem quite well. He should go back to the GP and say he needs a bit more time to rest and needs to be signed off for a further say two weeks. He should also be seen by a cardiologist if he hasn't been. But perhaps the chest pains haven't to do with his heart and are stress or digestive problems. But in any case it sounds as if he needs a bit more time off sick.

yes i hope its the former too.

He is quite scared to go back to work. In addition to the chest pains and shortness of breath / jawache he has an ongoing GERD issue. This is currently under control but he has his annual review (during work hours) and our ds has a big ASD appointment we are both supposed to be at. Plus i have major sugery in 2 weeks. None of which are to do with the chest issue he was signed off with but all of which i know he is worried about. He has also been on antidepressants and betablockers for anxiety for some time and I simply dont think he is well enough to return to work, esp given his job.

Is he not in contact with occupational health at work? Surely they'd be able to help judge whether returning to work in his normal role seems reasonable?

Definately don’t return to work
Phone gp tomorrow and ask again about the results
Ask what next because he is still getting symptoms
Ask what was his blood pressure? Are they going to give him anything for that? Did they check his kidneys too?

Walkingthroughawall I dont know. I will ask him

the 3 things that worry me are:
he is still having a lot of chest pain, angina, clammy, breathless
GP telling him at 5pm he should return to work in the morning after 4 weeks off even though he is also on betablockers for anxiety and antidepressants (both for around 2 years) and saying he does not feel well enough.
GP refusing to consider checking kids cholesterol even though Consult Cardiologist says to. seems odd that.

I asked him what his bp was but he said GP didnt say.
he gets quite stressed at gp appointments and didnt think to ask.
No kidney checks done no.

thing is, if GP wont sign off after today, surely he HAS to return to work?
(its a country practice, and this is the Head GP (who is notorious for not referring / signing off for anything ever so no chance of reconsidering or seeing a diff GP in practice)

That sounds very frustrating, I would ring his works occy health department and explain he is still having symptoms and you don't feel it is safe for him to return to work, they won't want to put him or others at risk. They may be able to work something out for him. Maybe he can have unpaid leave or annual leave until something can be agreed. With regards the GP, you can speak to your local health authority if you are unhappy with the treatment. Do you call an ambulance or go to a&e when he is having chest pain, angina and feels clammy with shortness of breath.

I will ask him to speak to Occy health yes. I dont suppose they'll spk to me. I have thought that if he has these symptoms again (and we happen to be in a different locale) it might be worth going to A&E there and see if they can advise (obvs we'd not bother them unless the symptoms were severe).

No, occy health won't be able to speak to you, he needs to make an appointment to see them and I would seek medical help with those symptoms.

He will have had his kidneys checked in order to have the contrast for the angiogram and CT.

Walkingthroughawall
Ah that is useful to know thanks.
Obvs i just have his feedback. He is severely dyslexic and finds it hard to take in / write down lots of info. Plus he broke his back aged 13 and finds medical 'stuff' brings him out in a cold sweat anyway poor chap.

I feel really angry with the GP for asking him to 'confide in her' so he pours out his worries and fears and at 5pm she says: 'back to work in the morning'. Seems cruel. And stupid if he is still having chest pains, clammy, dizzy, shortbreath etc. I simply dont understand how they can sign him fit for driving a double decker in a capital city street :O

Another vote for occy health. The cardiologist can also sign him off. They can't talk to you without your husband's permission but they can with it and you should be able to go with him.

GP should at the least do a 'fit note' so that he is not driving.

did well on treadmill test but Angiogram shows some Atheroma (roughening of arteries)

Did he have any symptoms on the treadmill? As a group of things yes he does need to be medically managed (IMHO) but the atheroma is not something they will be looking at treating yet. It is incredibly common. A study was done on US soldiers in Vietnam, 50% has the start of atheroma.

Has he been given any information about a cholesterol reducing diet?

Can you change GP?

You mentioned a cardiologist, if you call the hospital and ask for the cardiologist's secretary you might get another appointment, if GP isn't following cardiologists 'rules' the hospital might do the testing of the family.

Sassh thank you.
He just called me.
Starting driving again on Monday.

Did he go to occy health, hope he feels better and gets his pain sorted out.