DR ELLIE CANNON: I have a problem with my eye, so why has my doctor prescribed me heart medicine?  


During a recent eye test, the ophthalmologist spotted a burst blood vessel in one of my eyes and suggested it could be a sign of a heart problem. My GP diagnosed supraventricular tachycardia, and I’ve been prescribed beta-blockers. I’m 79, have no heart symptoms and feel in very good health. Could they be wrong?

Opticians and eye doctors often spot medical problems in a patient that would otherwise be missed. They include high blood pressure and diabetes, both of which cause changes in the eyes. This is one reason why regular eye checks are so important.

Supraventricular tachycardia is when the heart beats faster than it should, and this is often due to nerve problems in the upper part of the heart.

The pulse can suddenly speed up, then slow down. In some people it remains at a very high level – way over the normal maximum of about 100 beats a minute. If it occurs fleetingly, it may be otherwise symptomless, but it can cause dizziness, weakness, breathlessness and anxiety as the heart races.

Today’s reader went to have their eyes tested but learned they may have a heart problem

Palpitations – where you can physically feel the heart pumping – and chest pain can also happen.

It tends to occur more in people who smoke and drink, as well as if caffeine intake is too high.

To diagnose supraventricular tachycardia, particularly in a person with no symptoms, we use a 24-hour or 48-hour ECG – a type of heart monitor – to detect occasional events. A fast heart rate is easy to spot in the results.

If there are no symptoms or concerns, treatment might not be necessary. If damage within the eye can already be seen, it would imply that the episodes have been frequent enough to cause problems, so medication would be wise. Beta-blockers and other heart drugs are used to slow down the heart and prevent further damage.

I am plagued by sleepless nights because of the amount of mucus constantly trickling down the back of my throat. Initially I was fine in the daytime, but now I’m forever blowing my nose. My GP diagnosed post-nasal drip and prescribed a nasal spray. It didn’t work and I was given much stronger nasal drops, which also failed and gave me headaches and nosebleeds. I can sleep if I take Night Nurse, but I’m worried that this isn’t a long-term solution.

Post-nasal drip can be caused by allergies, hay fever, nasal growths called polyps, and infections such as sinusitis.

   

More from Dr Ellie Cannon for The Mail on Sunday…

Some people have chronic sinusitis, where the sinuses are always inflamed, leading to an over-production of mucus in the upper airways.

Often, sufferers can identify triggers in the house such as dust or cleaning products, or smoky rooms.

Post-nasal drip is also called upper airway cough syndrome, and there are specific guidelines for treatment that can help.

Night Nurse is a combination medication with antihistamine and decongestant – the recommended treatments to use. However, it also contains paracetamol, which isn’t needed in these instances.

Other treatments a GP might recommend include an antihistamine such as chlorphenamine, with a decongestant to reduce and dry up the mucus.

If sinusitis is also an issue, steroid drops or spray, or a nasal antihistamine, may help.

Long-term use of decongestants is not recommended, as these can end up making the problem worse. But long-term use of a nose-rinse – a salt-water rinse or spray – is safe. You can make it yourself, or buy it online, and use it to rinse out the nasal passages and wash away allergens.

I had an operation to repair my aorta in April last year but suffered something called a spinal stroke in theatre. I spent weeks in hospital and finally got out in June, but ever since then I’ve suffered a dreadful feeling of tightness round my trunk, as if I’m being given a bear hug. No one can tell me why. Am I the only person to have this problem?

It is very difficult to suffer with a condition that is misunderstood or rare, adding to the uncertainty that is so hard about any illness.

Do you have a question for Dr Ellie?

Email DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.

Dr Ellie can only answer in a general context and cannot respond to individual cases, or give personal replies. If you have a health concern, always consult your own GP.

A stroke is when the blood supply to the brain is interrupted, causing damage. If the blockage happens in the spinal cord, which carries messages from the brain to the rest of the body, similar things can happen. We call this a spinal stroke.

These are rare, accounting for about one per cent of all strokes. In both types, nerve messages to the body can be interrupted, leading to strange sensations, pain or mobility issues. The symptoms will vary depending on the nerves affected.

Unusual feelings in the trunk or lower part of the body would chime with this. Bladder-control problems and weakness in the legs are also seen.

A problem like this would be best dealt with by a pain clinic. A GP will be able to make a referral for you.

Waiting times can be long, but a wide range of treatments is available including medications, injections, physiotherapy and psychological therapies.

Further information is available from the British Pain Society (britishpainsociety.org) and PainUK (painuk.org).

We need more like Huw to speak up about depression

It was a breath of fresh air to hear BBC newsreader Huw Edwards speak so openly last week about his 20-year battle with depression. The presenter didn’t skirt around the cruel realities of the condition, telling Men’s Health magazine it often hits him like a ‘strong wave’, and he’s been unable to get out of bed. I was impressed to hear him say he still suffers.

All too often, celebrities talk about their mental health problem as if it is a thing of the past – and they’ve miraculously recovered. Anyone who has suffered a severe mental illness will know that the problem rarely just goes away. Most people find a way to manage, be it through therapy, medication or support of friends and family, and can absolutely live a full and functioning life.

Patients are often reluctant to visit the doctor for a relapse, as they find it difficult to accept they are still unwell after having treatment. If more people in the public eye spoke as honestly as Huw, perhaps others would seek the help they need.

It was a breath of fresh air to hear BBC newsreader Huw Edwards speak so openly last week about his 20-year battle with depression. The presenter didn’t skirt around the cruel realities of the condition, telling Men’s Health magazine it often hits him like a ‘strong wave’, and he’s been unable to get out of bed. I was impressed to hear him say he still suffers

It was a breath of fresh air to hear BBC newsreader Huw Edwards speak so openly last week about his 20-year battle with depression. The presenter didn’t skirt around the cruel realities of the condition, telling Men’s Health magazine it often hits him like a ‘strong wave’, and he’s been unable to get out of bed. I was impressed to hear him say he still suffers

Where are these extra medics? 

Apparently there are more doctors and nurses working in the NHS than ever before – according to a Government press release that landed in my inbox last week.

It also claimed that there are 4,300 more doctors than there were a year ago. I hate to be cynical, but something doesn’t quite add up. As a GP who works in NHS buildings most days, I am yet to see where these extra doctors are.

What I do see is desperate patients waiting weeks for an appointment because so many of our staff have either retired or quit. So I suspect some of these extra medics are part-timers or working at the top level of the NHS where they have little contact with patients.

Perhaps the currently over-stretched system is more to do with surging demand, but I highly doubt it.

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