Anyone vaguely clinical? Mother has had possible silent heart attack - not getting treatment

[handlemecarefully]

Mum - who is 72 and has suffered from high bp and angina for years (pattern of CHD in her family - a number of her siblings affected - 2 having died from it), had a sudden collapse about 3 months ago. Full blue light scenario, admitted to CCU.

Discharged a couple of days later. No conclusive diagnosis, but we are talking Scarborough DGH which I suspect is not likely to be a jewel in the NHS crown.

She was supposed to have a 24 hour tape within 7 - 14 days of discharge (she has just told me that now, 3 months later!!!), and subsequent to that was supposed to have an exercise tolerance or 'stress' test on a treadmill.

The hospital has cocked up big time. She was sent for her 'stress' test last Friday, whereupon they found that they couldn't proceed with this because they had forgotten to book her 24 hour tape to precede this. So now back to square one - they have to book her for 24 hr tape, await results, book her for stress test, await results, and then we might get somewhere. In the mean time, 3 months has elapsed without treatment etc.

So bottom line is that 3 months after a probable silent heart attack (GP's suspected diagnosis)we are getting nowhere.

If she has suffered a silent heart attack (and her continued shortness of breath after only light to moderate exertion would seem to fit this, plus feeling 'unwell'), has she not missed out on cardiac rehab? shouldn't she be on specific cardiac drugs. Isn't she at risk whilst she remains untreated?

I know she is a good age but her 3 yr old granddaughter loves her and needs her.

I intend to write to the hospital to demand that she has her 24 hour tape and stress test expedited (this isn't queue jumping because if they hadn't fouled up she would have been done already), but I would like to have my facts straight about what the treatment protocol and patient pathway should be for diagnosing and treating silent heart attack, with timescales.

Can any health professionals help me out?

[handlemecarefully]

Bundle, I guess it might be....perhaps I should google that. Thanks for the links again.

Cheers Flossam, that's helpful. Yes I think she is on GTN and having aspirin. I don't think she is on clopidogrol but I'll check...

Thanks again

[Flossam]

HMC, sorry that this has been such a stressful time for you. I would contact the hospital and ask them when the appointment for her 24hr tape will be. Put pressure on them. They have messed up.

As far as I can tell, the 24hr tape and the exercise tolerence test will determine whether further investigations will be required which are slightly more invasive (I'm thinking along the lines of an echo, then maybe an angiogram to see inside the heart). It will also as you say, give the physios some guidance as to how rehabilitate her safely if appropriate.

Is she on no medication at all? I assume she has been on the GTN (under the tongue spray) for her angina. Was she commenced on any medication in hospital? I'm thinking along the lines of aspirin, clopidogrol (my favourite medication name!)?

Lastly, age shouldn't be an issue. It is all relative IMO, my step father is 71, and is very fit, goes microlighting and gliding once a week each. 71 is by no means 'old' these days and should not have any effect at all over the type of treatment and diagnoses you are seeking at the moment.

[bundle]

if she's breathless without any exertion, could it be unstable angina? so sorry the tests have been delayed, it must be awful for her/you, xx

[handlemecarefully]

Bundle - she pretty much didn't get the crushing chest pain that features in 'classic' heart attack, but suddenly collapsed after feeling dizzy hence GP's assumption of silent heart attack.

I think the continued shortness of breath is consistent with a portion of the heart muscle having died (I think)...

Have rung British Heart Foundation and they are sending me leaflets on what diagnostic tests should happen and when, and also post MI recommended treatment....so thanks again for those links.

[bundle]

BHF: What is ?silent heart attack

A heart attack occurs when one of the coronary arteries which supplies the heart muscle becomes blocked. The classic sign of a heart attack is a persistent crushing pain in the centre of the chest. This often wraps around the body like a vice and may spread to the arms, throat, jaw, back or abdomen. A "silent heart attack" is a heart attack that happens with no obvious pain or warning signs and few detectable symptoms. Women, the elderly and people with diabetes are more likely to suffer from silent heart attacks. As with silent ischaemia, changes on their ECG is often the first time people who have silent heart attacks find out they have coronary heart disease.

About 60% of people who have heart attacks say they didn't have the classic symptoms. But about half of these people will have experienced some unusual symptom, such as dizziness or a pain like indigestion, which they did not link to their heart when it occurred.

[handlemecarefully]

You're sweet Droile, but please don't worry about me with all that you have going on.

Thanks Bundle - those are helpful links and I could certainly get some advice there.

[bundle]

Heart Information Line
Call the BHF's Heart Information Line

Heart Information Line - 08450 70 80 70.
Monday, Tuesday and Friday - 9am to 5pm. (staffed by cardiac nurses)

or here

[bundle]

sounds totally not-on. am only lowly medical producer, so can't advise on clinical stuff. have you been in touch with British Heart Foundation?

[Clarinet60]

They'll come. I'll look in later and bump if they haven't.
xxx

[handlemecarefully]

I guess not then.

[handlemecarefully]

Thanks Droile

[Clarinet60]

No relevant knowledge, but my heart goes out to you - it is so frightening when they cock up.
Hope you get good answers.