Chest pains in 43yr old DH, GP not worried?

[ravenousbugblatterbeast]

DH has apparently been having chest pains for a few months. He's always been "long-suffering" and so hasn't mentioned it to me apart from occasionally, in passing, when my reaction has been "go and see the GP then."

On Tuesday morning, after I'd driven him to the train (10 mins) he sat in the car looking uncomfortable. I asked if it was a chest pain, he said it was.

I persuaded him to let me book him into the GP, who by chance had a slot that evening. He came back with a referral to hospital for an ECG and chest x-ray, and was to go back "2 weeks later as his blood pressure was on the high side". I went to hospital with him yesterday, the person administering the ECG apparently said it looked ok.

The pains are still ongoing - last night he was sitting watching tv, and suddenly was hit by one. They're not agonising, but uncomfortable, and he keeps saying "something's blocked".

I know the internet is dangerous, but having looked it seems to me to be something like angina, although not triggered by effort or exercise. Is 2 weeks a little long to be waiting to see a GP again, only to be told (presumably) "tests are inconclusive, go and have some more"?

I'm getting wound up by this, he's obviously not happy and has admitted he's getting more concerned by them now, and not just shrugging them off.

From everything I've read, we should be seriously worried. Am I missing something..? The GP's off on holiday now, and while another has offered to see him, he's clutching at the straw that the GP obviously thinks it's fine, why rush it.

Sorry this is long, but I've decided I've got to be more positive towards him, to keep his spirits up, and I have no-one in RL to talk to.

I would get him to go back to the GP asap and not wait for the usual one to get back from holiday.

Go back and see the other GP.

Could he wear one of those things that produce a heart trace, for a few days, so that it can catch one of the episodes?

if he has pain again, go to A & E and insist on immediately seeing a cardiologist, or getting a transfer to the hospital's Chest Pain Assessment Unit.

Did he have his troponins checked? (blood test)

He really should have an exercise test at least, at best an angiogram.

Could be severe indigestion which often mimics angina but I agree you should go back and insist on further tests

Highlander - no! He didn't even have a blood test, just blood pressure and a general chat and a listen, apparently. No exercise test, nothing more than the cheapest, quickest tests available. He has private health through his work, but doesn't want to use it.

Gah!

The problem is, the more worked up I get, the more stressed he gets, and it took me months to get him to see the doc in the first place, so he doesn't want to go back again. We also have very little support here, and there's no-one to mind DS - typically it's half term now so I can't even bully him to go to A&E between 9am and 3!

I just don't understand how a GP who we know, and who seems pretty competent, can let a 43 yr old bloke with ongoing, randomly occurring chest pains, just hang about for 2 weeks. Am I missing something?

I would second his going to A&E.

My DH does have a heart condition, and on xmas day was having chest pains. He thought it was probably indigestion, so in the evening we had a long walk together to find a garage open selling Rennies.

That didn't clear it so he rang NHS direct. They said he'd better go in and get checked. So I dropped him off at A&E.

Well, he came home a few hours later dosed up with powerful antiacids and covered with ECG stickers, and they hadn't actually found anything wrong - he thinks it may in fact have been muscle pain following long drive in bad weather the day before.

But the point is, the people in A&E said he was absolutely right to get it properly checked. They would much rather check and find nothing than have someone leave it and then get carted in as an emergency or DOA.

A&E with you!

Ring NHS direct and see what they say?

(0845 46 47)

I know exactly what NHS Direct wd say. But why isn't a GP saying it? I mean, he didn't even tell him to take aspirin in the mean time - I've sent DH into work with a packet of dispersible aspirin with instructions to shove one in his gob if the worst happens.. Cheery - moi..?

What would they say do you think?

Not wanting to sound unsympathetic but what exactly are you after? Are you concerned because the GP didn't ring an ambulance and have your DH blue lighted into the nearest cardiac centre for a full cardiac work up? Making a diagnosis can take a little while. All tests come with associated risks so it's normal for a dr to start with the basics and go from there, unless the presenting symptoms warrant immediate invasive treatment. If the symptoms are persisting and causing you and DH concern, call NHS direct (what's the point of saying I know what they'll say ?) or visit A&E. That's what emergency services are there for. Good luck.

he probably didn't tell the GP how bad he was feeling

he sounds like exactly the sort of person who would go into the GP and not make a fuss

if it's reflux/indigestion, that aspirin will make him feel worse

I would take him to A&E and take kids with you if needed. Check him in and if needed leave him there and collect later. everytime I have chest pains and fast running heartrate I bypass GP and take myself to A&E, thats what I have been told to do. I have ongoing VTs, but everytime they do a ECG, bloods and sats, as standard. TBH if there was anything major in tests they have done they would have called, but tbh, I would take him.

Sorry - I'm not trying to be clever - "I know what they say" simply meant they'll say exactly what I think should/should have happened, and yes, he should go to A&E or at least get a full battery of tests scheduled asap. But I can't make him go to A&E, and my going on about it is only making him feel worse. Everything I look at on t'internet, and what's been said here, makes me think a GP shouldn't let even an understated patient (which I fully expect he was) wait 2 weeks before the most basic tests are addressed.

Sorry, I'm just worried and feel completely helpless. He's trusting the GP. He's never been ill before, at least not this (potentially) seriously, I just want to turn back the clock and make him better.

I don't know how GPs can guess with patients though - he might have only told them it happened that day?

what was his blood pressure?

is there a pattern to them happening?

ultimately, if he doesn't want to get medical treatment, there isn't much you can do. You can mention to him (gently!), that you think he seems to be suffering more and it might be an idea to go back to the GP on Monday.

A bloke in our office had chest pains last week and went to hospital and they kept him overnight. You can tell dh he was the same age . They did a barrage of tests and all came back normal in the end - they said he was fit as a fiddle (but with slightly high bp so they have given him a plan to help him reduce that). At no point did anyone ever say he was wasting their time. Doctors don't mind chest pains at all it seems .

I mean don't mind investigating them iyswim!

Dont panic, exserise tests arent given as standard and bloods are normally done by cardio team, well here anyways.

No you cant make him go to A&E, but my guessing would be if GP was concerned he would have sent him. You cant blame the GP for not doing the test you think he needs, especially if your husband has down played it (mine does that too!)

Sit him down, explained your concerned about him and would he please go to A&E for u

if you ring NHS direct, they will ask to speak to him, then THEY will tell him to go to A&E, I'm sure, then it won't be you fussing

I agree shalli - that's pretty much why I suggested it

If he has an episode of chest pain then call an ambulance (and i VERY rarely say that!). Not because I think he is in imminent danger of keeling over but because having a health care professional witness the pain, ask the right questions and do an ecg very quickly when it is still happening or immediately afterwards may well mean something is picked up right there and then. (Paramedics can do 12-lead ecgs on the spot). He won't have to go to hospital if he really doesn't want to although they will very likely encourage him to do so.

Doubtless you have been told this before but if you can get a clear idea of what the pain feels like (stabbing? tight? constant or on and off) and whether it is provoked by anything/changes (eg set off by curry/worse when breathing in/moves into the stomach) then that will be a great help.

How stressed is he?

My DH had chest pains last year as did a few people he worked with - men that rarely complain about any health issues. He had shortness of breath as well for a good few months.

I also developed health issues which lasted a year which were IMO entirely stress related.

Thankfully, our lives have calmed way down now and both our symptoms have disappeared. The effect of stress on the body can be huge.

But worth getting checked out if its stressing him......

From what I understand, your DH is seeing the GP in 2 weeks regarding his BP, so no, it's not a long time to wait. Normally they will do a series of readings to establish whether he has high BP or whether it was a one off (perhaps caused by the stressful events surrounding the initial appointment.)
It's impossible to establish from what you have written whether these pains are cardiac in origin. The best thing your DH can do is keep a record of when they are coming on, what he has been doing in the lead up to the pain starting,what had he eaten, and what,if anything relieves it.
Unless he's actually having chest pains, the A&E is a bit of a waste of yor time. However if he gets chest pain that is persistent, and doesn't ease off with rest or is still there after 15 minutes then go directly to A&E. You don't need to insist on a Cardiologist because a) you won't get one, and b) even the most junior A&E doctor will know how to order a set of investigations for chest pain, and take a history.If there is any suspicion of something cardiac then they'll investigate. Good luck with it all!

DH thinks they're cardiac pains, on the left side of his chest, passing to his left arm sometimes, but they seem to occur randomly, especially when he's resting, which seems to me to be a bad thing. He went to GP specifically for the pain, his BP was discovered to be high (180 over something - he left the card with it on at the hospital when he had the tests) as part of that visit. I'm just frustrated that nothing's happening for 2 weeks. It could well be stress related, as he always complains about being stressed, but he's very much a "glass is half empty and with poison in it" type of person, so gets stressed and down about things easily.

PATCDS - I see what you mean, thankyou - if it gets bad over the weekend I'll make him ring NHS direct, and hopefully he can't put them off!

I don't want to panic you, but: our GP took a fairly laid-back attitude to my DH's chest pains - he was highly stressed, working very long hours, overweight; the pains tended to be when he was exerting himself (walking fast up steep hills etc) and although his blood pressure was high-ish, I think he had an ECG which was normal. About a year later the pains seemed to have cleared up, and I think his blood pressure was down. Then he died of a sudden cardiac arrest, aged 41. Post-mortem showed ischemic heart failure, ie pre-existing heart disease. I would push your DH to get it checked out - better to make more fuss than necessary than wish you had when it is too late.