Anxiety or Heart?

[MrPatrickThai]

Hello,

 

I'd welcome advice from those in the know or with experience.

 

For the last year or so, I've had a strange feeling in my heart area. It's hard to describe the feeling, which is just under and to the left nipple. It's certainly not painful but I just feel it's there and there is often a kinda fluttering. I've always had a low heart beat, at the moment it's 60. In the past it's usually about 45, rising to 120 after exercise. I don't smoke or drink, but have a lot in the past. Been 20 years since now alcohol. I am 56 years old with grown up(well kinda lol) kids. I've got quite a few financial worries with kids studying abroad, and also big stress at work. I have a feeling it's hypochondria but for peace of mind I'm writing this here to hear if I should be seeing a doc or changing my life. I jog 5 km 2/3 times a week but also work 7  days a week most weeks.

Not really any other symptoms, just when I stretch my left arm, I often get a stitch.

 

Thanks

 

Patrick

Edited October 23, 2018 by MrPatrickThai

[Sheryl]

There are check up packages offered by all the hospitals and include EKG; the higher end packages include stress test or you can just add it onto a lower end package.

 

I recommend you have a general check up with stress test as it sounds like you have not had one any time recently. Should do this anyhow at your age, and the peace of mind will be well worth it.

 

Note that if you are taking a beta blocker drug need to not take it on the day of the test (befiore the test I mean - can take the missed dose after the test).

[MrPatrickThai]

5 minutes ago, Sheryl said:

There are check up packages offered by all the hospitals and include EKG; the higher end packages include stress test or you can just add it onto a lower end package.

 

I recommend you have a general check up with stress test as it sounds like you have not had one any time recently. Should do this anyhow at your age, and the peace of mind will be well worth it.

 

Note that if you are taking a beta blocker drug need to not take it on the day of the test (befiore the test I mean - can take the missed dose after the test).

Thanks for the reply.

 

I don't take beta blockers but interestingly, I use to abuse this drug(I know it sounds weird) taking 100 mg a day to try to stop the alcoholic shakes. 10 years ago+ I went to the doc as I was feeling faint, my heartbeat was 32. I got a ECG or whatever it's called and the doc said slight bradycardia but nothing serious. I suppose I'd better get it checked out.

 

How much would a heart test cost alone at a top hospital? I got a basic medical + prostate test recently.

Edited October 23, 2018 by MrPatrickThai

[MrPatrickThai]

Actually, I've never heard of a stress test. I wonder what it involves.

[Sheryl]

Usually about 2,000 - 4,000 baht.

 

You run on a treadmill attached to a blood pressure cuff and EKG machine.

 

Will show if there are ischemic changes or abnormal change in heart rhythm under the stress of physical exertion

[MrPatrickThai]

1 minute ago, Sheryl said:

Usually about 2,000 - 4,000 baht.

 

You run on a treadmill attached to a blood pressure cuff and EKG machine.

 

Will show if there are ischemic changes or abnormal change in heart rhythm under the stress of physical exertion

Thanks, just one more thing - would I have to fast before such a test?

[Hummin]

17 minutes ago, MrPatrickThai said:

Thanks for the reply.

 

I don't take beta blockers but interestingly, I use to abuse this drug(I know it sounds weird) taking 100 mg a day to try to stop the alcoholic shakes. 10 years ago+ I went to the doc as I was feeling faint, my heartbeat was 32. I got a ECG or whatever it's called and the doc said slight bradycardia but nothing serious. I suppose I'd better get it checked out.

 

How much would a heart test cost alone at a top hospital? I got a basic medical + prostate test recently.

For you age at the private hospitals from a basic plan to the more detailed one, it would be 12 - 18 000,- 

 

Some hospitals have good promotions, so my best would be to look around. 

 

I got a 2 year membership with discount on meds, check ups etc for 12 000,- one year ago. 

 

https://www.bangkokhospital.com/index.php/en/packages-promotions/health-checkup-packages

 

 

 

[lopburi3]

38 minutes ago, MrPatrickThai said:

Thanks, just one more thing - would I have to fast before such a test?

Believe they ask 4 hour fast but do not believe strictly required.  I personally have had less than perfect results from that test.  Some pointing to issues and other not.  Had a chemical stress test and no issues found.  Also have had several echocardiogram tests which seem to provide a great deal of information for those without real symptoms and is very easy to do.  Last one was at Vejthani Hospital 3 months ago costing 4,500 baht (pre-op requirement).

[Sheryl]

It is recommended not to eat for 4  hours before the test. Not a hard and fast rule, but I would suggest that if you eat that morning, eat lightly and several hours beforehand.

 

 

[rak sa_ngop]

If you haven't got one maybe borrow somebodies high end Samsung smart phone and use the heart rate monitor. It will give you a visual picture of your heart pulse and may help you identify missed beats or extra fast beats. I suffer from Atrial Fibrillation and my S-6  phone helps me identify and characterise the A-Fib events.

[MrPatrickThai]

20 minutes ago, rak sa_ngop said:

If you haven't got one maybe borrow somebodies high end Samsung smart phone and use the heart rate monitor. It will give you a visual picture of your heart pulse and may help you identify missed beats or extra fast beats. I suffer from Atrial Fibrillation and my S-6  phone helps me identify and characterise the A-Fib events.

Thanks, i have an S8. What's the name of the app?

 

Ok, I found it. some peaks seem higher than others. 50 beats per minute. Is it accurate?

Edited October 23, 2018 by MrPatrickThai

[wgdanson]

1 hour ago, Sheryl said:

It is recommended not to eat for 4  hours before the test. Not a hard and fast rule, but I would suggest that if you eat that morning, eat lightly and several hours beforehand.

 

 

The instructions for my hospital here in Phitsanulok say no eating or drinking 12 hours before tests....................BUT if you are having an ultrasound on your abdomen you need a full bladder !

[wgdanson]

27 minutes ago, rak sa_ngop said:

If you haven't got one maybe borrow somebodies high end Samsung smart phone and use the heart rate monitor. It will give you a visual picture of your heart pulse and may help you identify missed beats or extra fast beats. I suffer from Atrial Fibrillation and my S-6  phone helps me identify and characterise the A-Fib events.

You can buy a blood pressure monitor like they use at the hospital for Bht 2000 in Tesco. Then get an app called BP Watch, and put your readings into it, morning and evening. That way you can see how your BP is varying, and it gives your average. When I go to hospital I tell them not to do a BP test as it is probably high due to the stressful drive or 'white coat syndrome', or after the free cup of coffee they just gave me. I tell them my average for the past month or so. I know my average weight, and my height has not changed in 40 years. They still charge me Bht 300 for 'nursing services'

[Sheryl]

4 minutes ago, wgdanson said:

The instructions for my hospital here in Phitsanulok say no eating or drinking 12 hours before tests....................BUT if you are having an ultrasound on your abdomen you need a full bladder !

That is referring to blood tests, not EST.

[Sheryl]

16 minutes ago, MrPatrickThai said:

Thanks, i have an S8. What's the name of the app?

 

Ok, I found it. some peaks seem higher than others. 50 beats per minute. Is it accurate?

What you are looking for is nto the rate but the regularity i.e. any extra or "skipped" beats.

[wgdanson]

1 minute ago, Sheryl said:

That is referring to blood tests, not EST.

So if your check-up package includes blood test AND ultrasound??????

[Sheryl]

1 minute ago, wgdanson said:

You can buy a blood pressure monitor like they use at the hospital for Bht 2000 in Tesco. Then get an app called BP Watch, and put your readings into it, morning and evening. That way you can see how your BP is varying, and it gives your average. When I go to hospital I tell them not to do a BP test as it is probably high due to the stressful drive or 'white coat syndrome', or after the free cup of coffee they just gave me. I tell them my average for the past month or so. I know my average weight, and my height has not changed in 40 years. They still charge me Bht 300 for 'nursing services'

That is a hospital charge, fee for using the hospital.

 

in Thai the same word can mean nurse or hospital.

[Sheryl]

Just now, wgdanson said:

So if your check-up package includes blood test AND ultrasound??????

EST has nothing to do with ultrasound, so rather off topic.

 

If you are having a checkup that includes both blood work and ultrasound, fast from miodnight and refrain from urinating that morning if you can. Otherwise they may have you drink a few glasses of water.  contrary to what many Thai hospitals tell you the fasting does nto need to preclude water.

[scubascuba3]

Thanks, i have an S8. What's the name of the app?
 
Ok, I found it. some peaks seem higher than others. 50 beats per minute. Is it accurate?

I exercise a lot and have a chest heart rate monitor, it can vary from 48 when just woken up to 180ish during intense exercise, so depends what you are doing when you take a reading, even moving an arm can make it go up 10 beats

[kkerry]

17 minutes ago, wgdanson said:

The instructions for my hospital here in Phitsanulok say no eating or drinking 12 hours before tests....................BUT if you are having an ultrasound on your abdomen you need a full bladder !

 

Depends on where you go, 8-12 hrs. nil by mouth for fasting cholesterol test, 4 hours no eating for the treadmill stress test. Look on the internet and US hospitals don't seem concerned about drinking water but in Thailand they do.

 

I had a full medical recently so first thing was the blood test. Afterwards I was allowed to drink a bottle of water prior to the ultrasound and urine test. Asked about having a banana before the stress test and was told no food.

 

My stress test went well. Two previous ones were halted early due to a sudden spike in BP but this time managed almost fourteen minutes without issues before stopping as my hamstrings felt like they were going to explode. Still, shows how sticking to a moderate daily exercise program can help, with my BP the lowest it has been in years. I have bradycardia so my resting heart rate is normally around 50-60 bpm but hit 171 for the test. 

 

 

[scubascuba3]

 
Depends on where you go, 8-12 hrs. nil by mouth for fasting cholesterol test, 4 hours no eating for the treadmill stress test. Look on the internet and US hospitals don't seem concerned about drinking water but in Thailand they do.
 
I had a full medical recently so first thing was the blood test. Afterwards I was allowed to drink a bottle of water prior to the ultrasound and urine test. Asked about having a banana before the stress test and was told no food.
 
My stress test went well. Two previous ones were halted early due to a sudden spike in BP but this time managed almost fourteen minutes without issues before stopping as my hamstrings felt like they were going to explode. Still, shows how sticking to a moderate daily exercise program can help, with my BP the lowest it has been in years. I have bradycardia so my resting heart rate is normally around 50-60 bpm but hit 171 for the test. 
 
 

What exercise do you do for the stress test? Is it on a treadmill or cycle?

[Sheryl]

Treadmill

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[kkerry]

1 hour ago, scubascuba3 said:

What exercise do you do for the stress test? Is it on a treadmill or cycle?

 

I've only seen treadmills used for check-ups in hospitals here. Not sure but I think cycle tests are more for in depth testing of athletes.

 

Google Bruce treadmill protocol to get an idea of what happens. Twelve minutes is the usual testing target time with the speed and incline of the treadmill increasing every three minutes. They will let the test go on for twenty-one minutes if you're up for it but anyone over fifty who isn't a regular runner is unlikely to make it to the end imo.

 

When I had previous tests stopped at five and nine minutes due to spiking BP I felt perfectly fine. Further medical testing including a coronary CT didn't reveal anything of concern. Apparently this is the case for around five percent of people. I don't smoke, rarely drink alcohol now and have good cholesterol and triglyceride numbers. 

 

 

 

[MrPatrickThai]

Well they never asked if I had fasted before the EKG. it was only about 1 minute - I expected at least 5 minutes.

The doc said there was nothing wrong with me after looking at the EKG. He never  even listened to my heart, until I asked him to.

 

Good news I guess, but what could it be, still there like a kind of dull feeling and occasionally like I have just got a scare/shock. Stress would be the most likely cause.

It has been reduced a lot which makes me diagnose this.

[Sheryl]

36 minutes ago, MrPatrickThai said:

Well they never asked if I had fasted before the EKG. it was only about 1 minute - I expected at least 5 minutes.

The doc said there was nothing wrong with me after looking at the EKG. He never  even listened to my heart, until I asked him to.

 

Good news I guess, but what could it be, still there like a kind of dull feeling and occasionally like I have just got a scare/shock. Stress would be the most likely cause.

It has been reduced a lot which makes me diagnose this.

Did you have an EKG or a stress test? They are not the same thing.

 

1 minute, sounds like an EKG.

 

If it was a stress test yo uwould have bene standing in a treadmill, hooked up to the EKG and a blood pressure machine and running increasingly fast. It lasts on average 10-15 minutes. It would only be cutshort if there was a probklem (excessively high blood pressure etc) i nwhich case results would nto be described as normal.

 

A simple EKG cannot rule out cardiac arrythmias and will only detect ischemic heart disease if there is acute ischemia at the time of the EKG or a past infarction. 

 

It was suggested you have a stress test (EST) not EKG.

[kkerry]

2 hours ago, MrPatrickThai said:

Well they never asked if I had fasted before the EKG. it was only about 1 minute - I expected at least 5 minutes.

The doc said there was nothing wrong with me after looking at the EKG. He never  even listened to my heart, until I asked him to.

 

Good news I guess, but what could it be, still there like a kind of dull feeling and occasionally like I have just got a scare/shock. Stress would be the most likely cause.

It has been reduced a lot which makes me diagnose this.

 

If you want a stress test (not an EKG) then most large hospitals offer check-up programs with one included. Usually works out cheaper if you have one as part of an annual medical than stand alone. At 56 years of age you should be getting checked yearly anyway.