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Feel completely let down by GP/ Hospital watch

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    Hi all,

    I have been having palpitations/ sharp, stabbing chest pains in the left side of my chest for over 6 months now, and every time I get them they scare the living hell out of me. I have been to the GP numerous times, only to feel completely patronised saying that its because of anxiety. I understand that anxiety may play a role, but I still get these symptoms even when I'm not anxious. I've been to the GP and A&E several times (probably about a 8-9 GP visits and 3 to A&E) and every time its always the same. I get an ECG done which comes out normal (probably explained by the fact that I'm not having them at the time of my episodes). I also once had an ECG done at A&E which came back normal whilst I was having chest pain, but nothing was subsequently done about it.

    I am terrified I have something like myocarditis or AF as my symptoms seem to match perfectly, and being a medical student I feel completely patronised when the GP or the hospital try and send me away with a poxy ECG, with absolutely no justification or other investigations.

    Last month I asked my GP to refer me to a cardiologist to reassure me and the appointment letter came today, with yes- you guessed it - an ECG request form. I feel so frustrated that no one is taking me seriously, and my worries every time I get the symptoms are driving me mad

    What can I do, TSR? I'd also appreciate if any TSR medics can reassure me. Worth a try anyway.

    Replies from both medics and non medics would be much, much appreciated.

    Thanks all.
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    Oh, and I also had a blood test a few months back which came back normal, but I understand that myocarditis can go unnoticed even in blood tests. I feel like the only way I'm going to get reassurance is if these symptoms stop, and at the moment it looks like they're not going to stop any time soon because no one is taking me seriously.
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    I don't know about myocarditis, but if you have a normal ECG, you don't have AF. At least you are being seen by a cardiologist, so you can discuss your concerns with them. However, I also completely understand why, in the absence of any ECG/blood test abnormality, they're not exactly rushing to do anything more.
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    i often got this too (in my left side of chest too ), until i started getting stoned more often, which is why i think it probably is to do with anxiety
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    http://en.wikipedia.org/wiki/Precordial_catch_syndrome
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    sometimes anxiety presents as a symptom rather than a feeling so it still could be anxiety.

    also arnt medicial students know for overexagerating diagnosis when they are still learning.

    i understand you feel are annoyed (this is prob making you anxious.lol. - sorry i shouldnt laugh) but id go back to the gp and tell them how worried you feel and how you feel they are by passing symptoms or taking it all too lightly... in a nice way of course

    hopefully, for your sake they will send you for all the relevant test and you will come out all clear.
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    If the ECG's have been normal, i's unlikely to be AF, it will show up (i think!). If you have a referral then this could be a good thing, it could be a 24hr ECG. Which as I'm sure you know are useful when symptoms are intermittent. It sounds like the doctors are doing all they can, and you need to put yourself in their shoes- They're doing the right tests, and the right thing.

    When i suffered, or indeed i still suffer with anxiety it DOES come out of the blue. I don't get chest pains but i do feel like i can't breathe or swallow, and chest pain follows if i let it get worse. I had an episode today totally out of the blue when driving, popped the window down, did my hypnotherapy techniques, and sang along to the radio and i was fine. On top of the medical investigations, why not seek CBT, counselling or- like myself, hypnotherapy? They can be really good for those suffering with anxiety, and it helped me cope with it. I've not had a full blown panic attack in years now

    It is SO easy to get hypochondria when you're working in healthcare i've probably been fully convinced I have a disorder related to one of the areas I work in every time i start somewhere new. I even was concerned i'd need a knee replacement at one point lol
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    There are two types of med students... those that worry too much and end up seeing the doctor on a very regular basis and those that don't worry at all until they are ITU candidates.. - I can't remember who told me this but it is quite true..
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    You are a medical student and yet you think you know better than every single doctor you have seen? Ever considered your fear of something being horribly wrong is just another symptom of anxiety?

    Diagnosis - hypochondria.
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    At least you're seeing a cardiologist! What do you want them to do to demonstrate that they are taking you seriously? Give you unnecessary and possibly dangerous medication? Hospitalise you? Surgery??
    Just listen to whatever advice they're giving you and try not to worry so much. If it gets worse (pain or frequency) or you start having new strange symptoms, return to the doctors.

    Have you seen the same GP each of these 8-9 times?
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    9 GP visits and 3 trips to A&E!? Do you want to rent a room from the NHS? Will save on travelling.

    Apply what you have learnt in school:
    You are young, presumably have no cardiovascular risk factors.
    Your history is not typical of pain of cardiac origin.
    Examination including heart sounds are normal
    Your (repeat) ECGs, blood tests are normal.

    It is more than likely your chest pain has a non-cardiac cause. What do you want from the cardiologist? An echo? 24 hour tape?
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    (Original post by Helenia)
    I don't know about myocarditis, but if you have a normal ECG, you don't have AF. At least you are being seen by a cardiologist, so you can discuss your concerns with them. However, I also completely understand why, in the absence of any ECG/blood test abnormality, they're not exactly rushing to do anything more.
    I was thinking it was more paroxysmal, as it only seems to come on at certain times... but what do I know. It probably is anxiety and I just wish it'd stop.

    That actually seems to match my symptoms pretty well :p:

    (Original post by Grotbag)
    You are a medical student and yet you think you know better than every single doctor you have seen? Ever considered your fear of something being horribly wrong is just another symptom of anxiety?

    Diagnosis - hypochondria.
    I'm trying to convince myself that this is the case, but every time I get the symptoms, it all goes out of the window.

    (Original post by EskimoJo)
    At least you're seeing a cardiologist! What do you want them to do to demonstrate that they are taking you seriously? Give you unnecessary and possibly dangerous medication? Hospitalise you? Surgery??
    Just listen to whatever advice they're giving you and try not to worry so much. If it gets worse (pain or frequency) or you start having new strange symptoms, return to the doctors.

    Have you seen the same GP each of these 8-9 times?
    I've probably see about 3 different GPs. One of them did nothing to reassure me; the other two helped me explained that its not going to be serious. Each time, I came out convinced that my chest pain was nothing serious. However, as a few days passed and I got the symptoms appeared again, my worries started to increase again, leading to another visit! I just want something conclusive rather than a cheap and nasty ECG and just a few words.

    For example, yesterday I was sat at the computer working when out of the blue I got two incredibly sharp pains in my chest that made me feel as if I was going to pass out. They probably lasted about 10 seconds. Thereafter I started worrying again, and stopped working, leading me to vent all on TSR

    (Original post by Awesome-o)
    9 GP visits and 3 trips to A&E!? Do you want to rent a room from the NHS? Will save on travelling.

    Apply what you have learnt in school:
    You are young, presumably have no cardiovascular risk factors.
    Your history is not typical of pain of cardiac origin.
    Examination including heart sounds are normal
    Your (repeat) ECGs, blood tests are normal.

    It is more than likely your chest pain has a non-cardiac cause. What do you want from the cardiologist? An echo? 24 hour tape?
    :o: Yes, if possible. And maybe a chest X-ray. At least that will help put my mind at rest.

    Thanks for your replies.
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    (Original post by Anonymous)
    For example, yesterday I was sat at the computer working when out of the blue I got two incredibly sharp pains in my chest that made me feel as if I was going to pass out. They probably lasted about 10 seconds. Thereafter I started worrying again, and stopped working, leading me to vent all on TSR



    :o: Yes, if possible. And maybe a chest X-ray. At least that will help put my mind at rest.

    Thanks for your replies.
    Are you a first year?

    As somebody said before, you have been diagnosed by qualified doctors who know more than you. They wouldn't discharge you without good reason.

    "Poxy" ECG? "Cheap and nasty"? :rolleyes:

    Doesn't sound like you are symptomatic when you get these chest pains either.

    Come on, be sensible here...if you have AF you would be able to feel your own pulse rhythm and generally be symptomatic. Your ECG would show it as well!

    I really don't understand why people go to doctors and then poo-poo what they say. Why not save everyone the bother, stay at home and self diagnose??
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    (Original post by digitalis)
    Are you a first year?

    As somebody said before, you have been diagnosed by qualified doctors who know more than you. They wouldn't discharge you without good reason.

    "Poxy" ECG? "Cheap and nasty"? :rolleyes:

    Doesn't sound like you are symptomatic when you get these chest pains either.

    Come on, be sensible here...if you have AF you would be able to feel your own pulse rhythm and generally be symptomatic. Your ECG would show it as well!

    I really don't understand why people go to doctors and then poo-poo what they say. Why not save everyone the bother, stay at home and self diagnose??
    Second year.

    Well apparently an ECG costs about 30p to produce, and doesn't need much paperwork etc, and I feel that if nothing showed up the first two times, why would anything come up the third time? Why not send me for a different investigation? This is why I can't take them seriously. An ECG seems to be the simplest get out clause for them.

    They tell me nothing is wrong, then I find myself getting more symptoms when I get home. This is what worries me.
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    Hopefully all you have is this.

    http://en.wikipedia.org/wiki/Medical_students'_disease

    Why not tell the doctors you don't feel assured and ask them about your concerns? If they are half good doctors they will be able to tell you you don't have myocarditis or AF.
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    Thisss.
    I suffer from this, and your symptoms reaally sound very similar.

    Also, incidentally, I've had 4 major heart operations for 2 seperate heart problems, hole in heart as a baby and then leaking valve at 11, so when I got the symptoms for PCS a year or so ago I obviously went straight to my heart doctor, scared ********, and they did exactly the same kind of tests for me as for you, (as in ECGs and bloodtests), so don't assume the GP isn't taking you seriously, it seems this is the best tests they can do for these symptoms.

    I should also add that the reason they keep on sending you back for more ECGs is because the pain comes periodically, so the majority of the time the sound of your heart is going to be normal. Repeating the ECG (which someone above pointed out is a very cheap thing to do) is the best chance they have of catching someone they didn't see on the first or second, ie an attack of palpitations.
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    (Original post by Anonymous)
    Second year.

    Well apparently an ECG costs about 30p to produce, and doesn't need much paperwork etc, and I feel that if nothing showed up the first two times, why would anything come up the third time? Why not send me for a different investigation? This is why I can't take them seriously. An ECG seems to be the simplest get out clause for them.

    They tell me nothing is wrong, then I find myself getting more symptoms when I get home. This is what worries me.
    Since when did the usefulness of hospital tests depend on their price?

    Perhaps you weren't sent for another investigation because it isn't appropriate? If you aren't exhibiting the signs of valvular disease or cardiomyopathies etc why send you for an echo?

    I guess you just have to trust what they say...after all, people don't mess around with suspected cardiac pain. If there was any doubt as to your diagnosis, you wouldn't be discharged.

    If you are that concerned, you can always go private and pay for an ECG, 24 hour tape, echo, coronary angio, MRI etc just to be sure...but is it really appropriate?

    Also I reckon the unit cost for an ECG must be way less than 30p...the most expensive bit is the paper!
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    (Original post by Anonymous)
    Second year.

    Well apparently an ECG costs about 30p to produce, and doesn't need much paperwork etc, and I feel that if nothing showed up the first two times, why would anything come up the third time? Why not send me for a different investigation? This is why I can't take them seriously. An ECG seems to be the simplest get out clause for them.

    They tell me nothing is wrong, then I find myself getting more symptoms when I get home. This is what worries me.
    You sound like you need to get over yourself. You've studied medicine for one and a half years - you know very very little in comparison with qualified doctors who have probably been practising for years.

    You've got it into your head that you don't trust the doctors and that they don't care about you so that is why your symptoms aren't going away. You aren't reassured and you don't believe that there is really nothing wrong. I trusted my doctor and when she told me there was nothing wrong I believed her and guess what.. the symptoms all went away. You need counselling or CBT not more tests. Why should the NHS have to pay for expensive tests just to apease your hypochondria?

    And it seems unlikely that you myocarditis if your blood tests AND your ECG have come back normal. It's possible, but only a very very small posibility. Where abouts is the pain in your chest anyways?
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    As many of the others have said, you sound like you've been taken seriously by you GP/hospital and are under investigation so I'm not sure why you're feeling let down.

    In the absence of any of the symptoms you mention but fail to list other than the pain (although I can understand that the pain alone can be quite distressing), have you thought it could be something like http://en.wikipedia.org/wiki/Costochondritis ?
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    (Original post by Perfect_Gent)
    As many of the others have said, you sound like you've been taken seriously by you GP/hospital and are under investigation so I'm not sure why you're feeling let down.

    In the absence of any of the symptoms you mention but fail to list other than the pain (although I can understand that the pain alone can be quite distressing), have you thought it could be something like http://en.wikipedia.org/wiki/Costochondritis ?
    Thanks for that, that along with the other link posted by Fail Whale also seem to describe what I've been going through very well. Its really confusing as I was perfectly fine just a few months ago.

    Thanks digitalis, I know I'm being a complete moron with all the reassurance-seeking, but I just can't help it every time I get the symptoms!

    (Original post by flying twig)
    You sound like you need to get over yourself. You've studied medicine for one and a half years - you know very very little in comparison with qualified doctors who have probably been practising for years.

    You've got it into your head that you don't trust the doctors and that they don't care about you so that is why your symptoms aren't going away. You aren't reassured and you don't believe that there is really nothing wrong. I trusted my doctor and when she told me there was nothing wrong I believed her and guess what.. the symptoms all went away. You need counselling or CBT not more tests. Why should the NHS have to pay for expensive tests just to apease your hypochondria?

    And it seems unlikely that you myocarditis if your blood tests AND your ECG have come back normal. It's possible, but only a very very small posibility. Where abouts is the pain in your chest anyways?
    Its very specific, localised & sharp in nature, right at the apex and sometimes at the left sternal edge. The only reason it worries me is because it makes me stop whatever I'm doing and makes me worry about what could be up. And the palpitations don't help either.

    Would counselling really help if I can't even listen to health professionals? :o:
 
 
 
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