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How Soon to Seek Medical Attention

Re: an earlier answer a couple of days ago about how high pulse rates and how much can a heart take, you responded, "The majority of patients with afib and rapid ventricular response should seek medical attention soon after its onset." How soon is soon? My pulse rate sometimes gets up to 180 bpm. How long should I wait before I go to the ER. (That's the only option right?)Thank you.
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Avatar universal
Fazss,

I'm not a doctor, but a retired cardiology technologist. I will tell you a few things that may or may not help.
A heart attack typically takes 72 hours to evolve, which means your mother may not have had signs of one when she entered the hospital, but it evolved into one during the night. Did they do blood work? Did they do an echocardiogram? Did they JUST do an EKG? How about a chest xray? How about hooking her to a monitor? If they didn't do any of the above, you need to find another emergency room.
If they did and nothing showedup, they found a diagnosis of heartburn because those were the symptoms she was telling them she had. She would have had a heart attack regardless of them discharging her or not. How could they know what was to be in
a few hours? Doctors, no matter how impossible they seem, are not mind readers. If she had pains all day, surely she should have been calling her cardiologist. Sounds like this could not have been avoided, what with the plaque buildup. Bypasses generally last from 5-10 yrs, depending on diet, exercise, medication routine, medicine, etc. If she has a history of high cholesterol, you should have yours checked NOW. Do not wait as heart disease begins in the 20's. You know that McDonald's you had one day? That's a great start! Sausage is bad, any transfats
are nasty. Ice cream is a killer, as are fatty hot dogs. I am 56. I had a heart attack at 54, a failed angioplasty in which the incompetent doctor slipped, he said, and severed my main arteries in my heart. Yes, I saw the Pearly Gates and will not forget it. I am a triple bypass double stent person. The stents have closed, they close quickly. The surgeon had no hope. He told my husband my heart was a mess and that if I lived to tell the tale, I'd be lucky. It's 18 months yesterday and I'm still here :)
Stents do not last longer than 3 months as a rule. But, again it depends no diet diet and diet and exercise. No booze, beer, cigarettes, fats, cholesterol and low carbohydrates and an average person with bypasses or stents may live to 100.
Tell your mama to get some medication for that cholesterol as it's life saving and also to eat better and to keep working as it keeps her busy and active and helps her heart! I'm totally disabled now and can't work but I wish I could.
Sueing a doctor is akin to blowing air through a straw. You just can't do it. It's very expensive. You DO have to hire an expert witness, usually from out of state because the good buddy system is all over the profession and there is no way to get around it. That costs an estimated $2,500 for just an affidavit from some doctor you never met. It gets read in court and bingo! You lose. WHY? Because your mother would have died anyway from a heart attack, had they not tried to save her life. Oh, honey I know, I went through it all. I couldn't afford the affidavit, but my lawyers told me exactly what would happen. The statute of limitations here in my state is 2 years. Not even enough time for someone like me to regain enough strength to go after the incompetent fool. He can sue me for what the insurance didn't pay though :(
Just take care of mama, forget that hospital and the doctor that had no brain and go on with your lives. Maybe she'll be okay. Maybe that blockge is not a heart attack. Did the doctor state heart attack? Or just say blockage? Heart attack is damage to the heart muscle. Did she have further damage or not? It's hard to differentiate, but you need to study and read all you can about it. Ask questions. That's how I know some things. I may be wrong, but I think not.
Also, one last thing, please get yourself tested and your own life under control too. She shouldn't have to worry about you having a heart attack next.
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Avatar universal
Well what I've noticed is Doctors do make mistakes in diagnosis alot but when it comes to a lawsuit most the attorneys are not interested in heart cases. The general feeling is you would've had another heart attack anyway..."you were prime" or it's your own fault. Bad diet,family history,smoking etc. so it does'nt matter.
I did'nt have a bypass but was double stented and they say it will probably clog again before and after the stent. I never had any chest pain when I had my heart attack. I had gotten into some Muriatic acid that day and was having trouble breathing. The PA-C that saw me said he thought I had a heart attack. Overdosed me on Nitro, dropped my BP too low and guess what..I had a heart attack. Everybodys attitude seems to be...Oh well you were gonna have one some day anyway. Filed a complaint with the Medical Board. PA-C elected no to renew his license & left the state with a clean record. I guess mistakes happen in any business, thats how we all learn and gain experience. Trial & Error? I've just learned to stay away from hospitals and accept the fact I could die any day. And have gotten all my affairs in order. Call my family often. Then don't worry about it. I remember being upside down in a helecopter on Morphine being told I was'nt gonna survive. Next day I was walking up & down the hallways in the hospital wanting to go back to work. I would find your mom someone who is "Board Certified in Cardiology. I hate to sound negative but were all gonna die someday from something. If I had a choice I would drop dead while fishing ! Better than being in a plane crash. Good Luck finding a good Doctor.
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Avatar universal
My mom last month had heart attack, after six years from her first bypass.  The night she had attack, she was seen by doctors at the hospital and was told every thing was normal, even with the pain in her chest she was having the whole day.  She was released by the doctor with a heart burn diagnostic.  Later same night at 1:30 am she had attack and was taken in ambulance.  She had to go through angiopasty, she had plaque and blood clot in one  of the bypass vein.  Now we are so scared for her.  Doctor said the other two bypass are more likely to get blocked, she had tripple bypass in 1996.  She would't have had the attack if the doctor didn't discharge her htat day.  Need opinion on this type of situation.  If anyone was treated the same way, and what did you do later?  Will appreciate it.  And my mom is 60 years.  She has family history of high cholestrol.
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Avatar universal
Yea I agree, prior to my heart attack last year I only saw a doctor every 2 years for my CDL DOT Checkup. And never new much about the doctor business. Now my opinion has changed ! One hospital had me for two days giving me Librium & Morphine that did'nt even scratch the pain & when I asked why they were giving me that I was told for my alcholism (I had told them I had 1 beer a bingo that night). A cardioligist came in and ordered a echo and of course I had textbook Pericarditis.  Hurt when I would breath & I could'nt lie down. Later I came back to see the same cardiolgist and asked him for a release back to work and he said no, have your Primary release you back to work. I asked about my heart damage and he said he did'nt want to talk about it. Called my Primary and was also told no, I'm not your Primary. I had an abcess tooth 2 days before my heart attack, the abcess got as big as a peanut before I lanced it and a very dark blood and pus came out, took some antibiotics for 1 day and thought I was ok. NOT ! I have gotten nothing but vague answers here and still want to know if the "External Pacers" that were "arcing" above me was normal or malpractice. I think they were hooked up backwards or set too high. Either way that doctor moved on to a different state and elected not to renew his license. Way to much Hush Hush in the hospitals & still don't know what really happend to me. But I know alot of things were done wrong. No doctor will RAT another doctor off. You have to get an Attorney and BUY a Medical Expert if you want any true answers.
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Avatar universal
Vague replies .. sadly Doctors get sued when they try to do good as well.. but I in politeness I do dislike the vagueness. My dentist had to tell me what caused my heart attack .. toothing infection virus.   and not my Cardiologists.. who falsely  implied it was my smoking and drinking, which I never did..  I asked every related doctor, related nurse on a cardiac floor as  what were the visible symptoms of a heart attack and none there could  even agree...  all they could say to me is that sometimes in your life you had one..  one other person who had a heart attack like I did  also has the same symptoms I had.. chronic non stop  burping.. shortness of breath.. and speaking of specifics I also found out that EKG's tests required a professional cardiologist's interpretation and not any other doctor's, and even a previous comparison, thus both factors  led to diagnostic errors 50 percent of the time. I appreciate a well mannered competent cardioligist.
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Avatar universal
ked
Hi I am a 27 year old female.  My heart rate got up to 173 while sitting on the couch.  On the treadmill stress test it got up to 190 bpm.  My cardiologist put me on a low dose and now up to 100 mg of Toprol.  He now says that he can find nothing wrong and I should start winging myself off the Toprol.  This does not feel normal to me.  I have noticed a drop in my bp also.  I have started winging myself off the Toprol this week but I am so scared of having another episode but what do you do???

What is afib and rapid ventricular?
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Avatar universal
terk,

Thanks for your question.  I purposely left my answer vague because "soon" would mean minutes for an elderly person with a history of heart failure or heart attack, but might mean several hours for a younger, otherwise healthy person.

Some examples:
(1) 24 year-old male with history of multiple episodes of afib with rapid ventricular response (RVR) that are usually controlled by the taking of a medicine at the time of onset of the afib.  This person might take his pill and lay down for 2-4 hours while waiting for the medicine to work.  If the medicine did not work, or he became symptomatic, or the episode was lasting longer or was somehow different -- then he would need to go to ER.

(2) 50 year-old female with first onset afib and RVR.  She should proceed to the ER.  She may be fine; but she needs evaluation for her first episode to ensure that her afib is not from something else (like a blood clot, heart attack, thyrotoxicosis, etc.).

(3) 60 year old female with recurrent afib/RVR thought secondary to hypertension; now developing at 0500 am.  If this episode is like prior episodes, and she is asymptomatic or mildly symptomatic; then she may wish to call her doctor at 0800 for instructions.

The best thing to do is form an "action plan" with your doctor that suits your medical history.  Do this ahead of time and try to make contingencies for different times of days, holidays, etc.

Hope that helps.
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