A visit to cardiology: how low is too low?

Since my recent hospital admission the chest niggles I have been experiencing over the last couple of years have been somewhat more problematic.    So an outpatient appointment with the lovely Dr Denvir at The Western General on Wednesday afternoon was arranged.  Steve accompanied me, even though it was a hospital visit, as usual it was lovely to spend time just the two of us.

Got there with 10 minutes to spare – time for a quick pee, a plenty of time left over for walking to the clinic, getting checked in and taking seat in the not too crowded waiting room.  No sooner was my bum on the seat and my name shouted.  Weight, blood pressure and ECG all done before I saw the doctor. I took a seat back beside Steve and expected to wait quite a while.

Less than 10 minutes later Dr Denvir called on me.  Steve and I entered his consultation room.  He was wonderful gave us plenty of time to talk and ask questions, he explained everything in detail.  We discussed in depth the pain I get in my chest, how often, how I feel, etc.  I was telling him how at times the weight on my chest feels so heavy, other times the pain is worse, and my mouth gets very dry and then the saliva runs down my gums, I need to sit on the floor and wait on the pain passing. I feel very breathless.  It can take 15 minutes to go away.  He listened to my heart, had one of those poker faces – he didn’t have any kind of expression that would shout out something instantly to you,  and he did not make any sounds; no umming or ahhing, while he was examining me.  There was no guessing.   In a way it was reassuring.  He made me feel at ease.   He rolled up my trouser legs and said my your feet are very cold.

Steve told him I wear an apple watch, and told him about the heart app.  And asked how low should your heart rate go down to.  Dr Denvir asked why.  Steve told him I wasn’t looking too good so we looked at my watch to see what my heart rate was sitting at.  My heart rate was 18 beats per minute.  He looked at us,  well gadgets such as apple watches aren’t always exactly accurate, however that is low.  He went on to say,  they are sometimes 3 or 4 units out.

After our lengthy discussion, Dr Denvir has decided the best plan of action if for me to use a GTN spray when I get the pain.  He also sent me for an echocardiogram that day.  I got my heart scan on the Wednesday, so he could see what was going on.  He says that he believes that the problems are coming from my carcinoid syndrome.  He wants to see me  in 4 months, however if I feel worse before then give his secretary a phone and he will see me sooner.

As we were walking to the car,  I said to Steve he was very thorough and very nice; I like him, Yes, Steve said to me, but he didn’t say what was too low for a heart rate for normal.