Is Cardiology just a very odd area of medicine?

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Ds and I have both had recent experience of local hospital Cardiology Dept.

He was told: 'too young for a heart attack'. ('query MI' in his notes)
'probably Pericarditis', 'probably Myocarditis' can't tell without biopsy.
'Could be scarring, could be inflammation' (shows on contrast Cardiac MRI)
don't worry if your ejection fraction drops, it's probably anxiety causing it.
could be chostocondritis. probably due to your autism you are imagining it.
Probably anxiety not cardiac symptoms (but we suggest a 4th MRI to be sure)

I was told 'Pericarditis with pericardial effusion' (from CT thoracic)
4 weeks later 'no pericarditis - you probably never had it'. Just Anxiety' or a fatty heart probably'. Though it could be Angina. Can't rule out Peri however.
Your BP (207/115) will be affected by the recent windy weather, just keep taking it, 10 times if needed, till it comes down.

I thought it was just that Ds Cardiologist was poor (he was) but my experience was a bit weird too. Tbf, I am being referred for a CT Angio & given different meds now (GTN spray & BP meds) I understand that it can be hard to work through differential diagnoses but it seems both really vague (even though contrast scans done) and really decisive 'too young / too windy / anxiety'.

Is this just what Cardiology is like?

No. I used to work in cardiology and it was nothing like that.

DH works in cardiology. It’s one of the most competitive/prestigious/competitive fields so it sounds like you’ve had a strange and unusual experience.

My partner had a heart attack in his 20s and they didn't want to entertain heart attack in the hospital they kept diagnosing pericarditis as well. They thankfully sent him to a specialist cardiologist hospital where they picked up straight away the heart attack that almost killed him. The whole time he was also told he was too young.

That said its very specialist and changing all the time as so much research is put into it which is great.

I've worked with lots of cardiologists over the years and I haven't ever heard one of them say 'too young for X diagnosis' they may say 'it would be unusual for it to be X at your age' but they would never rule a diagnosis out based on age, so I think you me DS has had a really unfortunate experience there. (I'm not doubting this happens btw, just that a good doctor will look at every possibility).

It is an area where 'working diagnosis' is used a lot and it can sometimes take a long time to get to the bottom of what is happening (or has happened previously), often involving lots of tests and medication trials, which can be very frustrating for patients.

I find that the best doctors are the ones who are completely honest with patients, order tests 'just to check' or 'to rule out X', which is hopefully the experience you are having OP. It may take a while but this usually results in a decent understating of the aetiology and getting the correct treatment and follow up plan in place.

Btw, NHS choices does state that you are well within your rights to transfer your care to a hospital of your choosing, if you are unhappy with anything to do with your current care.

He was told: 'too young for a heart attack'. ('query MI' in his notes)
'probably Pericarditis', 'probably Myocarditis' can't tell without biopsy.
'Could be scarring, could be inflammation' (shows on contrast Cardiac MRI)

Well both pericarditis and myocarditis are inflammations ('itis' means inflammation) so it could be they could see inflammation but not sure where.

thank you for replying @AutumnFoxe @cardpin @Digup @LegoTherapy @sashh

Re Ds inflammation (Troponin was 2.5k on arrival & rose to 5.5K over 36 hrs)
We were told LVSD: 'he is very sick don't leave him' in High Needs (5 days). notes have no more written detail re LVSD (o/c MRI unreadable to us) Query Mi query Peri query Myo.3 gadolinuem MRI's & a 4th next week & each MRI has shown a lower ejection fraction left 57% (which I know normal) & right 47% but dropped 10% over 12m. Scarring 'or inflammation' is increasing. How can they not see more precisely? Is because read by Radiologist not Cardiologist? His Cardiologist simply won't show us/talk us through it (not qualified we learned)
At the same time we've been told he was 'fully recovered' in Oct & its all Psych.

With me I went in with high BP (197/115, pulse 48) & was sent home 'see GP' who sent me back. This time I was admitted, had ecg, Echo & CT thoracic. I was told variously 'just need to go back on HRT, musculoskeletal, murmur & Peri'. Went back for followup (same guy) & told 'no Peri never was, poss fatty heart, prob anxiety & indigestion, maybe Angina'. I appreciate a CT Angio is being arranged in 2m & I have meds for Hyperlipidemia & Hypertension. I have a strong family history of heart disease but Consultant not interested in that at all.
I understand he is trying to establish a differential diagnosis & he doesn't yet have detailed repeated contrast scans my Ds had (but they've not helped him!)

We are really rural Scotland. 2 Cardiologists @ small local hospital now seen both. No access to notes except after 4-12 weeks (as they are busy) & lots of redactions on Ds' notes. Unfortunately GP is not supportive. Which I realise sounds like an 'us' problem. Ds is Autistic. He doesn't especially present that way to a person who doesn't know him but he really is.NHS diagnosed (out of area) We crossed swords with the GP years ago over refusing to recognise this & it's been bad ever since. GP & Consultants know each other socially (rural!) Of course we can change GP but we're still stuck with the local Cardiology dept.

Sorry for futher essay. Ds feels that this is just 'the way Cardiology IS'. I was hoping there is better 'out there' & that he should try to access a 2nd opinion.
So, I was posting to see how 'typical' our experience is I guess?
Thank you for your replies. I''m somewhat isolated & it's really helpful for me.

Potentially your problem is being in a small rural hospital rather than a big teaching hospital. My DH works at the latter. You get the best doctors there.

could you ask to be referred to a teaching hospital?

Hmm. I just got the copy letter sent to my GP.
There are some things missing (I reported episodes of significant central chest pain upon exertion & at rest when dozing on sofa as well as - once - at night)
He seems to have decided it is 'night time reflux' from gastric surgery in 2018.
It isn't, I've was checked for it by endoscopy then & have had no symptoms since either. I eat small meals & no later than 6pm It can happen at 6am.
No mention of headache. No mention of heart racing. He says:'anxiety, or reflux but cant I exclude Pericarditis, atypical angina or coronary spasm secondary to a rise in BP (again probably anxiety)'. He records my ave BP as 20 points lower than it is. No mention of my Hyperlipidemia. Recommends a CT Angio (helpful).