Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Is this a cardiac or GI issue?

Forum: The Heart Forum
Topic: Palpitation



For about 6 weeks, I've been experiencing palpitations and ,along with it, GI symptoms such as tenderness in the upper GI area, and the need to burp, or have a bowel movement (just a feeling). I experience both together only occasionally (about eight times in the past 6 weeks), and always between 2 and 5 am. I usually awake to the GI activity first, then experience the palpitations (last about 10 mins each at about 150 bpm).

Consistently (almost every night), however, I wake up at this same time with some GI "activity" (sounds, discomfort).

The palpitation episodes are becoming more intense with one following another after about 15 mins (maximim 3 in one night). I am also experiencing a "draining" feeling before and after these episodes.
My PCP believes it is a mild form of gastritis, and has suggested a generic form of Zantac - 1 tablet before bed. After taking this once, an hour into sleep, I awoke drenched in sweat and experienced both chills and palpitations (just one episode).

Some mornings after these episodes, I awake with energy and normal health. On others, I awake drained and weak. I've also noticed on occasion that after simple exertions such as a flight of stairs or being startled, my heart responds more strongly than it used to (pounding, elevated rate).

I am wondering whether this is a cardiac issue more than a GI one? Any insight will be appreciated. Thanks.

Dear Mary, thank you for your question. I also suspect that you may be having gastritis and I think you may not be taking enough Zantac to combat this problem. The episode you describe after taking your first dose of Zantac sounds coincidental to me and does not sound like an allergic/adverse reaction to the medication. Gastritis may provoke premature beats (which cause palpitations), but that is an uncommon cause. The most common precipitants of premature beats are alcohol, tobacco, caffeine, and stress so I suggest that you try to avoid those precipitants as much as possible. Most often, premature beats are entirely benign and do not portend a bad prognosis. However, I suggest that you speak to your physician about the palpitations for further advice and possible diagnostic tests.

I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

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