As promised, here is a thread outlining my experience seeing the cardiologist yesterday, to discuss my concerns about whether over 3 months of post #covid19 symptoms has impacted my heart, despite no cardiac symptoms #longcovid 1/n

Naturally, the NHS is under even more pressure than usual during the pandemic, so given I have no cardiac symptoms during the last 3 months, I'm not expecting them to have the resources to allow me to see a cardiologist to investigate further. I understand that 2/n

So this is about me, as a #longcovid patient wanting some data, some more information about from a long term perspective. Have there been changes to my heart that I should be aware of, given these past 3 months have been a bizarre journey of symptoms? 3/n

I don't have insurance, so just like my other visits to specialists, this was self funded. I went online yesterday lunchtime, combed through the online patient reviews and within 3 hours I was sitting in the consultation room with a cardiologist 4/n

He wasn't just a regular cardiologist but quite an accomplished one, so I was surprised I got to see him at such short notice. I'm lucky I guess. It takes me 2 weeks just to get a slot for my car to be serviced! 5/n

I arrived 15 minutes early, he called me in 5 minutes before our scheduled time, and apologised for keeping me waiting. We are starting 5 minutes early though, I said :-)

He has lots of experience as a doctor but without the arrogance 6/n

I had emailed my medical records which included recent blood tests, my clinical summary from Emergency department visit (where ECG/Troponin tests done) and my CT Angiogram report (done in January 2020 - no symptoms, just as preventative check, result was normal) 7/n

He told me he had looked through all the documents extensively, but wanted me to tell me story of the last 3 months and why I'm here. He listened with complete attention, interrupting only to ask clinically relevant questions as per my story 8/n

He was also interested in my experience with seeing the rheumatologist and neurologist, and what they said/found and he wasn't just interested in my heart only but me as a person and my overall wellbeing, not just in terms of specific clinical outcomes. Very cool! 9/n

So he's seen patients like me before, i.e. post covid patients, quite a lot each month. Some with cardiac symptoms, some without, but all of them concerned about cardiac complications from covid-19. He acknowledged my concerns, saying covid-19 can indeed impact the heart 10/n

He shared what he had seen including where he had seen one patient who was a marathon runner, who got covid-19, recovered quickly, went back to work and later in time, had a mini heart attack. My concern is valid and the risk is real, he told me.

I felt "heard" 11/n

He discussed how he knows other doctors (not just cardiologists) who believe that these post covid symptoms that me and others are experiencing are just down to "anxiety" and nothing more. He is deeply upset that some doctors have that attitude 12/n

We had a great discussion about the latest theories, research etc on how covid-19 might impact the heart (and how so much is still unknown) and he didn't talk down to me or try and patronise me, it was a genuinely collaborative consultation. He was curious and open. 13/n

He didn't jump in to "let's just order a load of tests" but took the time to discuss with me what might be worth checking based upon my specific history and concerns, and what the value of each test would be, from a clinical perspective 14/n

He was also conscious that given I'm self funding, he didn't want to waste my money per se just running endless tests. It had to be a measured approach, where both of us believe that there would be value in the next steps 15/n

We decided on a 24 hour Holter monitor (fitted yesterday) and an echocardiogram (later this week) and I would see him for a followup after the echocardiogram to review results and see if a heart MRI is warranted (as they are really expensive!) 16/n

We discussed that whilst the heart MRI would show the structure of the heart & give a lot of info, if it shows very mild scarring as a result of covid-19, then nothing we can do about it, but more of a case of let's just have an annual check up, now that we know it's there 17/n

Regarding the 24 hour holter monitor, he didn't just want me sitting at home and having a relatively low heart rate. He wanted me to try elevating my heart rate, fast walk, etc to see what the monitor shows during exertion. I have to keep a diary of what I do, symptoms etc 18/n

He was in no rush to end the consultation, allowed me to ask as many questions as I wanted (I ask a lot, btw) and was friendly, warm and compassionate the entire time with plenty of eye contact 19/n

It cost me £250 to see him, £395 for the Holter monitor, and it will be another £585 for the echocardiogram and I think £200 for the follow up visit

That's £1,430

20/n

So for the Holter monitor, I elevated my heart rate briefly this morning. First of all I did a fast walk for 20 mins (no issues with fatigue or breathing) 21/n

Then I tried a 4 minute jog (I hated jogging even before I got sick due to knee pain) but surprised myself by managing to jog (Yes I was winded at the end but no chest pain or knee pain) 22/n

1 hour after this physical activity, as I was changing my t-shirt at home, one of the electrode stickers came off from my body! The nurse who put the monitor on told me replacement stickers were in the envelope in case this happened. Alas, no stickers in the envelope! 23/n

I made a 90 minute round trip back to the hospital in order to ask them what to do? A nurse saw me quickly and put a new electrode sticker on my body, apologised for the missing stickers, gave me 3 replacements for today and told me to wear the monitor for 26 hours in total 24/n

As I've finished this thread, my 26 hours is up, and I can now remove the monitor and finally have a shower!!

The monitor is not waterproof so they told me not to bathe or shower for 24 hours.

Did I tell you I managed to jog for 4 minutes today? I'm still in shock /end