rapid heart beat with distended abdomen

I have experienced rapid heart beat associated with hard ,distended abdomen in the midriff area usually after eating but has occurred in late evening as well made  worse on standing, walking. the episodes don't last the same amount of time and on a couple of  occasions, symptoms were relieved by bowel movement.  twice, when this happened, I was short of breath and did not feel right and on these two occasions,  I went to ER. all cadiac enzymes were normal as well as EKG, CXR and echo stres test. the first episode was 2 years ago. The only change in my health, of significance, occurred last year when I had a partial nephrectomy for clear cell cancer of left kidney.  All folow up scans have been normal. I am diabetic and taking Glucophage, Zestril and Crestor along with Fish oils, baby asprin, vitamin E, B 50, Slo-niacin, soya lecithin, Centrum.  I have been taking these medication for over 5 years now.

[Kevin Pho, MD]

There has been a pretty good evaluation of the heart - with normal EKG and stress echo.  I would also check a TSH to evaluate the thyroid, which can also cause a rapid heartbeat.  Another consideration would be the use of an event monitor - which can record the heart rhythm when you have episodes of the palpitations.

Regarding the abdominal symptoms, further workup including an upper GI series or upper endoscopy can be considered to see if there are any diseases (i.e. GERD, ulcers, or anatomical abnormalities) which can lead to your abdominal symptoms.  If negative, an abdominal CT scan can also be considered.

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

[CoghanB]

I'm waiting for a comment on my question, and saw this.  I used to have exactly this same thing!  I would sweat sometimes with this and think I was dying because of my heart pounding and my blood pressure would go straight up. Often the episode was followed by diarrhea.  My Dr. said that it was a "food bolus" caused by the fact I was eating too fast and too much for my body to handle.  He said it was made worse by the high anxiety and stress level I had at that time.  My stomach also empties slowly (probably due to no gallbladder) so I'm sure that didn't help.

To correct it, he gave me the two cup rule.  Basically that means that I wasn't to eat any more than two cups of anything or any combination of things that weren't green vegetables in one sitting.  Also said not to eat french fries or large portions very heavy red meats like steak and to avoid all pork.  And to chew chew chew my food before swallowing.  With every meal I was instructed to drink one glass of water even if I was having pop or something else.  Following this advice corrected the problem immediately, so I hope your problem is as easily corrected. It also helped me curb my appetite so that when I was ready to lose weight, I had a good foundation of controlled eating to start with.   -- CB

[yoshi]

why no pork??

[CoghanB]

Dunno exactly, but I do know that many people have a bad reaction to pork. I've seen two people pass out (my skinny wife being one) after eating pork barbeque and I can say for myself that pork has never settled on my stomach.  My amateur guess is that it has something to do with the fat content or the fact it is usually prepared with a lot of salt down here in the sunny south. All I know is I followed the advice and was able to enjoy my meals again without worrying about having that sick shakey (shaky) heart attack feeling and bloat.

My worst bout was after eating a steak house cheeseburger with cheese fries.  My heart rate went up to 120 for over an hour and my blood pressure rose to 180/100.  I felt like I couldn't breath and was absolutely certain my death was upon me.  My stomach was hard as a rock and I wanted to throw up but couldn't.  I don't know if my Dr. was correct in the diagnosis, but I do know the advice worked perfectly, so thought it was worth sharing.

[cmauro]

I am so relieved to hear you had the same symptoms as I because I was beginning to feel I was neurotic.  When yo mentioned the burger, I remembered the first time it happened to m e.  My son was in the hospital having surgery for a brain tumor.  His fiancee and I were there all day without eating.  When we finally left for the night we went to the diner and had cheeseburgers with fries.  I should pay you instead of my doctors who totally ignored my symptoms.  Thank you so  much. I always thought it was related to the food I ate but since I didn't seem to eat the same food each time it happened I figured I was wrong.  It's a wonderful feeling knowing you're not crazy or have a heart attack.  thanks again and God bless.

[CoghanB]

Well it is interesting that you were eating a similar meal when it first started AND you were under an extremely high stress situation like I was.  I've learned to do a lot of things differently to keep myself feeling well.  Among them is to learn not to eat any heavy foods at all when I'm really stressed.  If I'm under major stress load but I know I have to get a meal in, I'll go for yogurt or soup, then have a more normal size meal when the stress lets up a bit.