Hi folks, some of you might have seen my thread about the heart attack.

I’ve got a problem. I’m getting conflicting opinions from my cardiologist and GP. I am 39. 5’9 and 13 stone and physically active, cycling 30-40 miles off-road mountain biking and playing 5 hours of competitive badminton a week. I had a mild heart attack on the 21st of December. In for three days. PCI stent and although no high blood pressure or high cholesterol put on the usual gambit of statins, ace inhibitors and beta blockers. My echo was excellent with very little damage to the heart muscle. EF of 64% and no hypertension noted. Apparently, family genetics have been the main issue.a

The problem I have is that my gp has just told me this morning 4 week minimum off work, I’m self employed tax adviser and IFA and no exercise for at least 6 weeks and no travel. Whereas my cardiologist has said drive after 1 week and back to work in two weeks. No medical reason not to travel after this point other than insurance.

I started walking to the local shops a couple of days ago and can walk at a fast pace without being breathless for the 3mile round trip on the flat (45mins) Cardio rehab doesn’t start formally until 6weeks but I feel great. GP not happy at me walking at this stage.

All of the advice seems to be for older less fit people. Anyone any advice on cardiac rehab for fit 39 year old? Apparently according to the standard cardiac rehab for old people manual I can play indoor bowls today

GP = general

ologist = specialist

any advice

= go see your ologist

family genetics

&

PCI stent

Identified & corrected = enjoy the rest of your time. 😀

I would listen to your GP, not an internet forum

@ 39yrs old, search around for a cardiologist who has experience of rehabilitating sports people post MI

Not in the medical world, but have seen a few cardiologists over the years.

My thought is that your cardiologist is the specialist whereas the GP is just a GENERAL Practicioner.

Unless, of course, your GP is a former cardio specialist!!

Ask the GP to detail their exact concern, and mention your Cardiologist’s words. It might help.

+1 for tell your GP what your cardiologist said.

+2 for tell your GP what your cardiologist said.

Important to be transparent and keep each informed of the others opinion and of your informed preference.

I’m not just taking opinions from an Internet forum. I explained to my GP that my cardiologist had a conflicting opinion and it was his view that he did not see west of scotland genetics every day on the front line and it didn’t matter that I am extremely fit.

I should not be walking more than 400yds a day for the first six weeks, he then gave me my first doctors line I have ever had for 1 month.

I’m self employed and will be working from home. It’s the exercise and travel that I need advice on.

I had an MI when I was 36 and was advised more or less the same.

No stents needed and it is arguable whether I had one at all, but the underlying message was not to do anything strenuous for 6 weeks as you say.

I struggled to walk too far for around 1 week and was out of energy quickly but didn’t really suffer from anything else.

Didn’t drive for 6 weeks as I was told it was an insurance standard and chose not to question it (I too could work from home).

What was more annoying for me was the black and white attitude from my GP. Despite thoughts and opinions from cardiac specialists the GP refused to listen about drugs. Statins all but wrecked my cycling and I stopped them after a year.

As for the direct question, as others have said try to make sure everybody concerned with your health knows each others thoughts and use the GP as a route to the information as he/she will keep all your medical notes collated.

Might be worth checking your car insurance too as they may adopt a blanket approach to driving after an MI.

EDIT. If you wish to talk directly to me about anything related to it, please feel free to send an email to the profile details. 🙂

Always side with the cardiologist in affairs of the heart..

I think the sensible think to do would be to listen to what each has to say, make your cardiologist aware of your GP’s concerns and your GP aware of your cardiologists opinions and then following those conversations go with whatever the cardiologist says.

You have to remember your GP is liable for anything he advises you outside of safest practice, so that’s always going to be his last word. I went back to work 8weeks early following an operation but I had to get the specialist to email in writting that I could do this as a doctor would only advise I was not fit for work. Call the surgeon’s secretary and ask him, he won’t mind and its the safest course of action to take, you don’t want to cause yourself permanent damage for the sake of impatience.

+1 for going with the cardiologist. Can you speak to him directly? Maybe you could phone his secretary and ask if you could get a call back to discuss things? Your cardiologist will know exactly what stents he put in, what the rest of the arteries looked like, your heart function (not just the EF) etc etc, plus has presumably put a few stents in people from the West of Scotland before so knows what he is dealing with.

In terms of driving, the official DVLA guidance is that you can drive after 1 week from a heart attack if the heart function is good or mildly impaired on the echo scan, and 4 weeks if it is moderately impaired or worse (or you haven’t had a scan). If your EF is 64%, then that is in the normal range and you can drive after a week. There is no need to inform the DVLA.

The advice that I usually give regarding travel after a heart attack is the same as what your cardiologist has said (bearing in mind that I obviously don’t know the details of your case).

Best wishes,
Hannah (Cardiology Registrar)

I think you’ve been given the best advice in the posts above.

Something intrigued me though. I see that you mentioned your weight, height and age. According to the NHS BMI calculator that makes you “overweight”, but the reality is that you have an active lifestyle (and I assume been in good health up to now?). So I wondered if anyone you’ve seen along the way mentioned BMI? I.e. what advice is given in reality compared to the blanket BMI bracketing advice?

Wishing you a speedy recovery in the new year!

Thanks for the advice all, especially Hannah. I’ve left a message with the cardiologists secretary.

Yes, I’m about a stone overweight. Planning on losing this and have lost 3lb in the last 10days. Cholesterol and bp both normal. Don’t drink and don’t smoke and my vice is nice food from time to time.

Resting hr was 60 before this, so pretty fit. BMI has not been discussed at all.

Heart attack was a wake up call…….

PS hope 2015 sees a full recovery for you.