Cardiology - a bit worried...

[bellainthemiddle]

Apologies in advance for what's likely to be a long and rambling post...

I've been feeling under the weather for about a month and a half with what I thought was a virus type of thing. Been to GP, viral type of symptoms have resolved but the general feeling of being really tired / dizzy / random racing heartbeats has not. My bloods were OK-ish: no anaemia, slightly low vit B12 but (apparently) not low enough to be concerning. GP was concerned about the dizzy spells and fainting, which should not apparently be happening to somebody 'young and fit' and said she would refer me to cardiology. I was totally taken aback, so only said fairly brainless things like 'oh!' and 'are you sure?'

I sort of feel (and hope) that I am going to be a massive waste of cardiology's time, and that my GP is just being super-duper conscientious; but a tiny little bit of me is worried that they're going to find some dire, hitherto unsuspected problem! I wish I'd asked more questions at the appointment, and I'm sure the doctor did suggest the things they might do, but I had clearly gone a bit blank! I've no idea what to expect and not sure how concerned I ought to be. Does anyone have any idea what I should be expecting?

It's a good thing that your GP is referring you. Better to get checked than it being dismissed.

My visits to cardiology have involved talking about my symptoms and answering questions about them.

Listening to heart and ECG followed by a monitor that I wear for a week and then they assess result.

They referred me on a separate date for an echo, which is basically like an ultrasound scan.

Don't worry too much, it's good to get checked out

Thanks for the reassurance and info, it's good to know what might happen there. I have this totally OTT idea of cardiology being a place of great drama! Hope that they have sorted out (or at least diagnosed) your issues there.

I'm actually really glad that the GP has referred, definitely better than just being dismissed. I was just taken aback because it hadn't even vaguely crossed my mind!

I was referred to cardiology for dizziness, feeling faint and other symptoms although in my case I had to convince my GP to do so and its not until I showed him the results of my fitbit that he agreed my resting heartrate was abnormally low.

I had ecg, cardio and some over device that is checking my heart rate for 5 days and will do the same with a blood pressure monitor.

Echo and ecg came back normal though so great news. Cardiologist recommended cutting down all caffeine and increase water intake and I have to say it seems to make a difference.

Having monitored myself for a while now, it seems to be linked to my hormones so some weeks are fine and others terrible. It also linked with the quality of my sleep.

I expect to be discharged next but am reassured it is nothing bad although still hard to live a full on life with these symptoms.

Good luck with your appointment.

In your case, I'd be interested to know how low your B12 is and whether a bit of research on your part would indicate that it does need treating.

It would be worth getting the figures and reference ranges for B12 and folate. Your symptoms suggest this may be where your problem lies.

Thanks for all the replies!

According to the test results, the B12 range is 160-800 ng/L and mine was 159.

The folate result was 5.9 ng/ml, which seems to be totally normal.

B12 worth following up on, do you think? I have tried to figure it out by researching online, but every site seems to say something different regarding the ranges and I can't figure it out at all!

I have Paroxysmal Supraventricular Tachycardia (PSVT) which involves your heart suddenly racing for seconds, minutes or even hours and then it slows down to normal abruptly. I would be dizzy too, almost fainting and could feel the pulse in my throat. I would sometimes have chest pain and would sweat. Fortunately mine was caught on an ECG during an episode. I was referred to cardiology and had an echogardiogram, blood tests and was given a holter monitor to wear for three days - it records your heart's activity. My thyroid function was also checked. What I have can happen to young healthy individuals with no structural heart problem. Some people can have it and not know. I'm older and unfit, so perhaps have more severe symptoms. I take a calcoum channel blocker now and all is good.
Try not to worry about your appointment, I'm sure you willbe fine. Hopefully, if it's anything at all, it will be something simple.
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Ugh, ignore your uninformed doctor about B12. 159 is low and you would be considered deficient in many areas of the UK and severely deficient in other countries.

It needs to be a lot higher. Symptoms can present below 500-600. I'd advise taking a b-complex and a separate sublingual B12 supplement. Your folate isn't drastically low but it's not a very good result either. The two often go hand in hand.

I was referred to cardiology a couple of years after complaining to my gp about palpitations. It seemed like a very routine referral. I went along the following morning and was hooked up to a 24hr monitor by a nurse and sent on my way.

During that particular 24 hrs my FIL suddenly collapsed at 11pm and died of a heart attack - we arrived at their home before the ambulance did and went to have an awfully upsetting night, which included a contingent of us visiting him in a sideroom in A&E to say our goodbyes. If there was ever a night to cause a heart trace to react, this was it. I got 2 hours sleep before I returned to the cardiology dept to have it removed.

My tracing was fine.

Don't be concerned OP, the doctors really prefer to be safe than sorry when it comes to young people and possible cardiac symptoms. In most cases your heart will be absolutely fine.

Thanks everyone, for the infos and reassurances! I am slightly at loss for what to do now - the vit B 12 thing is concerning me and especially since I do already take a B complex supplement (I'm vegetarian) I'm not sure what to do! I'm trying not to get in a state but at the same time, I'm feeling a bit fed up since I've been a bit ill and exhausted since the middle of August and I'd really like to get back to normal :(

Just returning to this as things have unfortunately not gone to plan! Community Cardiology rejected the referral as 'inappropriate' and said it should be sent to the hospital instead. Hospital said it should go through CC first and said I should ask GP to resend the referral. I did, but CC said they haven't received it. GP sent it again, but CC still haven't received it - it's all electronic, so it should go through same day.

I feel bad about making a fuss, but I'm getting frustrated because I'm still feeling rubbish and, because nothing has happened in over a month since the original referral, I don't know what the problem may be. I did ask the surgery if it was possible to redo the B12 blood test (on the hospital's advice) and it came back the same, but marked as normal again.

If anyone has advice I'd be sooo grateful. I just feel like I'm getting nowhere, GP surgery is busy so no appointments, and not sure what I can do! I'd just like to find out what the problem is and start taking steps to deal with it. Or perhaps there's no problem and I just need to change my diet or take supplements - but I'd like to know!

This is so frustrating op. Usually the difference between an appropriate referral to community cardio vs acute are the tests they believe are required. 48 hours ccg shield be done in community, however if an ultrasound or more test are required such as tilt test, then a referral to hospital would be required. Maybe your gp needs to expand on the issues so that they can be clearer as to what is required.

Re. B12, this is complicated as you can normal standard results but still have an issue of absorption. The standard NHS test tests the levels of B12 in your blood but not what level is then absorbed and sent to cells (not very well medically describe but it's something like that). If you google B12 NHS testing and get on the NHS website, it explains this.

My levels were in the low normal range so my gp dismissed it even tough my mch levels were very high which is a direct indication of a B12 issue. In the end, I decided to order some and self inject. It took me a number of loading doses to finally stabilise and now only need one injection every month or so. Sadly GPs are not very well rehearsed on B12 deficiencies.

Thank you @swingofthings! I do feel like there could be something in the B12 thing, but I might just hang on till I can afford to pay for the private blood tests (it has been an expensive start to the school year!). I'm slightly scared of over / wrongly medicating myself if I try to fix it myself! I take a supplement already, so I'll continue with that.

TBH I'm tempted to give up on the Cardiology thing. It's obviously nothing that worrying because I guess that someone would make sure I got seen if it seemed really urgent or concerning. So I figure I'll just let it go and ask them to follow up if things get worse.

Ho hum! Thanks for all the advice, everyone x

The great thing about vit b12 is you can't overdose. Your body will get rid of any excess. That's why it is, safe to self medicate. Do google it, everywhere will confirm you can't overdose on vit b12.