Heartburn or Heart Trouble

I'm 34, female, overweight with a history of gastric problems and premature ventricle heartbeats.  In 2001 I had my first endoscopy that showed chronic gastritis.  I was put on prevacid and took it for a while,eventually I stopped taking meds and was fine. Then I started to have heart palpitations and underwent 24 hour testing and echos and was told I had benign PVCS.  

In May of this year I was taken to the ED with gastric pain and a high white cell count.  I was hospitalized for three days.  I had a CT scan with contrast, nuclear PIP? test, and ultrasound.  I had "slush" near my pancreas but nothing else was found.  Just before discharge I was given another endoscopy that showed no problems.  My doctor ordered an outpatient MRI that showed no problems.  He calls me his mystery patient as now the "sludge" is gone and all tests are negative.

About two weeks ago I noticed a slight heartburn in my upper chest, neck area.  It got progressively worse and two times it was difficult to get a deep breath because of the burning pain.  I called my gastro. doctor and he called me in a prescription for aciphex and told me to also take Gaviscon.  I've noticed an increase in my pvcs during this time as well.  This is obviously a high-stress time, but I guess the basic question here is can acid reflux come and go and is the painful breathing part of it?  I don't have any other cardiac symptoms and my last echo was just a few months ago.  I'm having frequent problems with belching and gas.  I just don't see how this could be all gastric and would like some reassurance as I can't get into my physican for two weeks.  I have been on the presription for five days and have noticed a slight improvement.  I drink a lot of diet cola everyday and am trying to stop.  I notice this pain even when I haven't eaten.  Thank you for your answer in advance.

[Kevin Pho, MD]

Gastric reflux can certainly present with similar symptoms to heart disease.  Given the fact that heart disease can have more serious consequences, I would completely rule this out first.  A stress test would be reasonable to further evaluate the heart.

Other tests to evaluate a GI cause would be a 24-hr pH study to definitively evaluate for GERD.  If the symptoms continue despite the Aciphex, then surgical treatment may be necessary for treatment.  

You may want to discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b