Medical Query: 'Disturbances in Heart Rhythm'.

j24

Newbie
Hi,

Not sure if there's still anybody on the forum who can provide medical advice on certain conditions and issues, but I will post anyway in-case somebody has experienced something similar, or who have also fallen under this category..

Just over three years ago, I went to the infirmary next to my campus at University with a concern of an awareness of my heart-beating. It happened once on that day and I thought it would be convenient to get it checked out seeing as an infirmary was so close by. Was nothing too alarming, could just feel my heart take an extra beat. The Dr put me on an ECG and after ten minutes of monitoring picked up two ectopic-beats, or more medically known as PVCs (premature ventricular contractions), and confirmed what it was. After taking me off, the Dr reassured me that it was completely inconsequential and it didn't surprise her with me being a student: 'stop drinking energy drinks late at night whilst writing your essays, caffeine is a common culprit with these', and sent me on my way. She was right, cans of cheap red-bull from the off-license a couple nights before helped me with meeting a deadline. After that, forgotten about.

Only until I put my application forward for the Royal Marines recently, and then found the updated Medical Eligibility and guidance [AFCO5] notes under Heart and Cardiovascular disorders: Disturbances in heart rhythm, as a possible bar to entry.

This sent me into sky-fall with anxiety, as it jolted my memory back to going on an ECG at Uni, and fearful it was put on my medical records after submitting myself to the infirmary those three good years ago. When I checked with my GP, the notes were there that I'd had this ECG done. [F*ck]

After more reassurance from my own GP, she said they were normal and most, if not all people experience at least one ectopic-beat per day, some people are aware of them, others aren't. I explained to her about 'disturbances in heart rhythm' on the medical guidelines for the RN, and she said she wouldn't class an ectopic-beat, or 'heart palpitation' as a disturbance in heart rhythm. Something like A-fib, or Supraventricular tachycardia would be [which are medicated with Beta's]. Her reassurance unfortunately wasn't enough as my GP isn't an SMO from Lympstone, and probably isn't fully aware of the demanding physical stress and rigours of Commando training... Still, I requested to have an echo-cardiogram to make sure there was nothing wrong with my heart.

Whilst having my echo done, the technician said my resting rate was around 54 and query'd if I participate in endurance training. I told her I competed in the BUCS Cross Country at Uni and was training for the Marines, as-well as a die-hard XC MTB'er. It confirmed and reassured her that I have a mild form of athletes heart. She said if I wasn't somebody who trains, it would have been a concern for her, for a 'normal' person to have a resting rate below 60. It's called Bradycardia, apparently. Other than that, my heart was structurally in top form [BP: 120/70: optimal range].

I went home and did some research on athletes heart [syndrome], and some top athletes like Chris Hoy, who has been reported to have a resting rate as low as 28, perplex cardiologists, because their heart rhythms are grossly abnormal on ECGs. I even actually read somewhere that some Marines are so fit, their hearts have S3 gallops out of their normal heart rhythm range. Clearly a result of endurance training. Chris Terrill narrated on his Commando on the Frontline series that by Commando phase, each recruit will have the equivalent fitness of an international athlete. Makes sense..

I haven't got to my medical yet, and I'm really concerned in telling the medical examiner about this and it becoming a PMU. I feel like I've shot myself in the face by getting a sticky-label put on my medical records, because I don't live with 'heart palpitations', or take medication for anything. My GP saw the anxiety it was causing me and said if she could remove it for me, she would. [Unforunately it's all on an NHS national database now.]

Jeeze, long post! But thanks
 
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j24

Newbie
Also funnily enough, I saw a recruit in training post a tweet on Twitter saying: 'Ectopic Heartbeat, we meet again'. So clearly recruits are having these during training.

So I'd really like a medical officer to explain what the guidelines mean surrounding 'disturbances in heart rhythm' and how they are classed as bars. There's such a broad range of arrhythmia's, from harmless to serious, so it makes the guideline a little convoluted and confusing.
 
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squashedbanana

Lantern Swinger
I'm in no way medically qualified so I can only speak from my own experience. At my RN medical I was made TMU for a suspected heart issue - which was the first I'd heard of anything like this, been training with no issues, never been to the doc with any issues, I was fit and healthy until he routinely 'listened' for problems with the stethoscope. My point saying all this is - if there is something there, it will most probably be found and you'll be TMU whilst they investigate. Best course of action if you proceed and get booked in for a medical, go to your GP and get them to give you written reports etc on everything so you can give this to the doctor administering your RM Medical. You need to declare existing medical issues as if not and it is a bar to entry you will get you booted even if you've begun basic training. I'm guessing many people do attempt to join thinking they're fit and healthy, go to a medical and something is actually discovered that they didn't know about and they can't join. It must be frustrating but unfortunately it's just one of them. I can understand the RN's point of view that the issue is not only your health during training etc but the impact this has upon your oppo's should you become unwell. I think you should apply as it may not be a bar to entry but again, I'm no Doctor
 

j24

Newbie
I agree. I just somehow think it's going to be a significant issue somehow. When the Drs are listening to your heart with a stethoscope though, they're listening out for abnormal sounds and echo's the heart can make. Murmurs basically. Luckily there's two types of murmur's: functional and physiologic. The physiologic ones are the types where your heart most likely has a structural defect and is a bar to entry, whereas the functional types are considered benign and innocent, the result of just an extra sound the heart makes. My mate who has gone infantry is serving with an innocent murmur
 

IlikeB33r

Lantern Swinger
As Squashedbanana has mentioned.. if you are declaring it. Make sure you have all the the relevant supporting documents to take to your medical. If you've done any tests to prove you are fit in this region by a GP- take it! Chances are you are still going to be made TMU and possibly sent to a SMO to give the answer but as long as you have more supportive information with you, it can't hurt. I only wish I done that when I was made TMU to shorten the process!

I wish you the best of luck!
 

squashedbanana

Lantern Swinger
Yes I know of a few serving with murmurs too so wasn't to panicky given my clear history. Just sharing my experience is all. Anyway do yourself a favour and take a bunch of paperwork with you if you go for a medical will save you time in the long run. Try as you'll always wonder what if. All the best
 

j24

Newbie
Yeah thanks guys. It's just really difficult now carrying this anxiety on my shoulders, with a potential PMU round the corner, it's actually quite stressful and worrying. Is Angrydoc, or somebody qualified still not active on here - who can get a solid, evidence based answer? PRMC forum say he's [angrydoc] a genuine SMO. Also, would AFCO staff not be able to deal with this kind of query, or would I have to wait until I get to the MO who will then send it to RN medical top-brass?
 
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IlikeB33r

Lantern Swinger
Yeah thanks guys. It's just really difficult now carrying this anxiety on my shoulders, with a potential PMU round the corner. Is Angrydoc, or somebody qualified still not active on here? PRMC forum say he's [angrydoc] a genuine SMO. Also, would AFCO staff not be able to deal with this kind of query, or would I have to wait until I get to the MO?

I'm not Doctor (obviously) but your situation seems a bit sticky for a careers adviser to give you a definitive answer... But what do I know! You could ask the AFCO, maybe Ninja knows a little?
 

j24

Newbie
My mum and girlfriend however say ignorance is bliss. 'It was three years ago and you were told then it was no issue of concern. The first Dr told you to forget about it. You were told by your own GP it's no issue for concern either, whatsoever. So don't declare it'.

I had to explain to them though that failing to declare anything that's present on your medical record can result in a dishonorable discharge. I'm aware that during day two of RT, you have a second thorough medical, where the MOs check your vaccinations, inoculations and also, so I'm lead to believe, scan through your passed over medical records to make sure there's nothing foul at play through misinformed information or deception from the first medical. I'd love to know what they would say during RT with it being discovered and me having no clue that it was an issue, through both time and forget - I don't suffer from anything symptomatic to have made me go back to the Drs about it.

If it wasn't for the updated Medical Guidelines PDF, this would have been the case for me. Because I managed to print off a previous edit of the guidelines where 'Disturbances in Heart Ryhthm' isn't listed. It was only the updated guidelines I came across that ended up shock-fully re-jogging my memory.
 
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I was cleared to Commando Course with an arrhythmial and a resting HB of about 51 at the time. However, I was in Service, and I required a RN Surg Cdr Consultant Cardiologist to clear me. I suspect you'll have a bit of a wait, but should be fine.
 

j24

Newbie
Thankyou Alfred, sounds a little re-assuring. My mum [she's the one trying to keep my head level with this issue] even said: 'one of their senior cardiologists will just test you and get you cleared'. My mindset takes these things as black and white, I know that's not a good thing. However, because it says 'Disturbances in Heart Rhythm' as a bar, I instantly think the door is closed. Every case is assessed individually I've also been told, so I think I need to strictly look at this objectively.
 
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