GERD, Esophageal Spasms, and Heart palpitations

I have been suffering from episodes of pain and discomfort in the epi-gastric area. It feels like I am going to have a heart attack, it is a pressure/discomfort in upper abdomen and back between shoulder blades with palpitations and difficulty getting a deep breath. It seems to come on as an "attack". I find that it happens most during my walks for exercise, when bending over, before or after meals, and also before bowel movements. I have had several tests run: abdominal ultrasound normal, several EKG's normal, Echocardiogram showing MItral Valve Prolapse, Endoscopy showing gastritis, eosinophilic esophagitis, incompetent LES. I have been taking Achipex in the AM and Zantac in the PM. Plus really watching what I am eating.  It seems to be OK for awhile and then like out of the blue I will get one of these attacks. I'm not sure what else to try, the Dr's haven't been very helpful. The last few episode I went in feeling terrible and left feeling the same way, their only suggestion is to double up the medicines. I really believe that the episodes are been caused by the esophageal spasms, is there any way to treat that other than double up the Gerd medications?

[CalGal]

If you believe you're experiencing esophageal spasms you may want to consider checking out the activity of your esophagus via esophageal manometry.

Esophageal spasms can be treated via anti-spasm meds or if those fail to help, the use of specific calcium-channel blockers or nitroglycerin. It may or may not work, but also understand that these meds have side-effects, too.

As far as the eosiniphilic esophagitis, you need to consider taking a very close look at trying to find out what specific foods may be causing the problem. It's very possible that some of your other symptoms may stem from the presence of this problem. There are at least 2 decent sites that discuss exclusion diets, which can be very helpful with this problem - and they're not typically GERD diet. So consider googling and searching into the 'cause' of EE.

I'm not sure about the PPI you're taking, but some PPIs are known to cause electrical conduction changes in the heart which can contribute to the palpitations.

[bigkev414]

Hi
I have very similar problems to you. Mine also often make me breathless like asthma and can last for a couple of minutes to hours. Sometimes for days on end with 'breaks' in between. I have had it for years; some nights I can't sleep because of all the activity in my innards and palpitations. I try sleeping sitting up - its worse when i lay on my left side. I have tried everything including natural therapies like SLIPPRY ELM POWDER to try to relax things - works a bit sometimes. Also take fizzy soda water with SWEDISH BITTERS in it (just about a spoonful) and that helps a lot. Try your health store for that. The only drugs that work are Xantac (sometimes) and I take effervescent tablets which dissolve and work instantly. Other than that a small dose of Valium usually gives me relief and calms things down for a few hours, I don't take it regularly or often. Things are always a lot worse during periods of prolonged stress which upsets my stomach and so on.
I feel OK for a while and then out of the blue it starts up and can last intermittantly for days or even weeks, slowly improving and kind of stops and starts during each day.
This probably won't help much but try the things I take - there's nothing to lose. Please let me know if you get 'puffy / asthma' like feelings when you are feeling bad. You are not alone, and we can only do our best. I've had all the tests too, and the doctors can't help much. They kind of give up if their first prescription doesn't work. We have to try to sort it out ourselves once we know what the tests show.
Good luck - please drop me a note. Kev

[GV40]

Thank you for your comments and suggestions, it is frustrating when Dr.'s won't look further into symptoms. I don't really believe that the PPI's work for me but I am taking them so they can't say I didn't give it a try.
I am in the midst of doing some food allergy testing, I am hoping that this may be a big contributor to the stomach problems. I had pretty bad asthma as a child which I thought I outgrew, but with the test results showing the eosinophilic cells I believe that allergies probably factor in to all of this.
My Dr. did not recommend further testing for the esophageal spasms so I wasn't aware of any test they could do for that. My Dr.'s just say "yes, the spasms are painful and they can feel just like a heart attack". I find those comments very helpful!

[Wholiness]

Hello, just wanted to say that I too have been suffering with esophagul spasms which bring on heart palpitations, breathlessness and even twitching.. plus constant discomfort in my chest on my left side about where my ribs are... Ive been trying to figure out for some time what's causing this and I think i got it down to parasites causing my stomach to spit food back up. So i started on a parasite cleanse, and it seemed to really help. Then I stopped taking the parasite cleanse and it flared right back up again like a storm. I also found that taking probiotics, especially ones like bio-k which can be bought in health food stores (for a price) or acidophilus pills (kept in fridges at health food places) help a lot too. Of course, probiotics simply are the enemy to bad bacteria that infest the stomach and make these problems worse. Whenever I take things that are anti-bacterial ie. garlic, ginger, chamomile tea, cayenne pepper... things seem to get better, then they go back. Truth be told though I get really strict with my diet, like eating only whole foods and nothing refined ie. white sugar or breads (which actually contribute to yeast overgrowth and feed other possible bad bacteria)... but thing is i never stay strict long enough to totally cure myself. My goal now is to do a strict and full parasite cleanse with no giving up, as hard as it can be (you have to give up a lot of things for it to work like alcohol, sugars, etc etc) and see how that goes. But I can honestly say that this suffering im sure is more common than even most doctors realize, and in the end the only real cure I believe is to get to the root of the problem: a little thing called bacteria which feeds of your nutrition, destroys your intestinal good bacteria, and in the end your stomach can no longer digest food properly so it spits it back up and you get esophagul spasms, which are SOOOOO discomforting, not to mention always feelin like theres something wrong with your heart and a host of other problems. I discovered too that continuous esophagul spasms can eventually lead to vagus nerve damage, and this nerve is connected to every part of your body including your heart... so that would explain why when this starts happening all kinds of things start to go wrong. I felt really good before all of these symptoms came on me. But, yea, Ive realy found relief from probiotics, anti-bacterial agents like the stuff thats in parasite cleanse, and even taking digestive enymes to take some of the load of my poor stomach. I wish anyone who has this the best, and my heart goes out to you, cause these symptoms are nothing anyone should have to live with, and hopefully not for ones whole life. If anyones reading this and has time to do so, please check out other sources on google or whatever for parasites and your stomach... you may be surprised as to the information you find. Good luck!

[ovalorbit]

You may want to ask your doctor to do stool tests for parasites, etc. and also a colonoscopy with biopsies.  I found out after 4 years that I had microscopic colitis.  This can only be found by examing the tissue under a microscope.  Just a suggestion...  After I started taking Entecort EC (a non-absorbable steroid) the bloating and diarrhea calmed down.  Before the diagnoses, some of my symptoms also included the pains in the upper abdomen and heart palpitations.  Cardio tests all showed normal other than a slight click.  I would not rely on any herbal products or second-guess anything if it's causing breathing problems, tightness in the chest area, rapid heartbeat or any serious cramping, etc.  You can also have your parathyroid and calcium levels checked.  If your blood calcium or PTH are high or out of balance, a variety of other issues can occur and even lead to stroke.  (see www.parathyroid.com)  

[beenthere4awhile]

i have been searching these sights for almost two years trying to find someone who has the same symptoms i do. i am having a flare up as i sit here writing this tonight. for over 10 years i have been "suffering" alone and not much hope or help from the medical community. upon initial test 10 years ago, i was diagnosed with pvc's and gerd. taking heart meds and nexium did absolutely nothing for them except a few extra trips to the hospital every year.
i have discovered along the way that i have the flare of symptoms mostly when i am sick to my stomach. i will have esoph spasms and palps for a bit of time before i start with diarhhea and vomitting. i have also noticed that when i have increased my water intake and eat a more healthy diet i have less episodes.i have incorporated fresh fruits and/or veggies with every meal and i drink an average of 3 to 4 qts of water daily. i also have eliminated all sodas and caffeinated drinks.  i have cut my flares to about two a year and no hospitals in almost a year now.i have also stopped all prescription meds and no longer require the service of my cardiologist. i do take magnesium and potassium with a multi vitamin to help the heart muscle remain strong and beating regularly. i went from hopeless and depressed to having an active and hopeful every day. i pray this may be of help to someone and thank you for posting. this can all be very uncomfortable and i am not in the clear, but have made it very manageable. i still pray to get through it when it happens, but i also know that i am praying about it a lot less than before. God bless  

[BarqueSailor]

Thank you very much!! I had an episode the other day; an esophageal spasm that triggered a brief heart palpitation. I was overheated and doing strenuous cardio exercise. I accidentally chugged down a big gulp of ice water and slush... you guessed it; I thought I was having a heart attack. It only lasted about 10 seconds, but to put it mildly, It was not fun. A trip to the ER confirmed my heart was OK, and one of the docs suggested an esophagel spasm. I was hopeful, but not totally convinced. After reading your entry I feel much better. Best of luck to you and all others that have posted here.

[Shiralee]

It is my prayer that this becomes much more common knowledge, especially among the entire medical community. If I am lying down to go to sleep and begin to feel and hear my heartbeat I know by this time that I should simply go into the bathroom and do the necessary. Only THEN can I get back to sleep. After years of ambulance, ER trips, etc. I have had to come to my own conclusions about this. It may be that the gastroenterologists know this and are not sharing. SW

[crambone]

wow,,,i have finaly found someone who has the exact same thing i get.
i have had every test u can imagine,and nothing!!!
also i have had the liver,heart,pancreas,and gullbladder (gallbladder) all cleared,and found to be in good shape,arteries also!!
so i wouldnt worry too much about it,,,i too have some gerd once in awhile,but i take a pepcid complete in the morning,and in the evening,and i think this helps.
i notice mine comes on sometimes when im sitting down too,and when i get up and stand straight,it often feels better,but mine too comes on in "attacks" lasts a few minutes and goes away.
im sorry to hear you have this too,but im glad im not alone.

[viking67]

Hi,
I have heart palpitations. Been steady every day for the past 3 months (this episode anyway). Sometimes I get 1 or 2 days of relief but mostly steady. Cardiologist has cleared me of any serious heart problems but gave no explanations or help.

I have had stomach/chest problems for the past few years. Sometimes so severe that its hard to breathe. I know now that most of that problem came from hard-core drinking. But I don't do that anymore... and I still have stomach/chest discomfort (causing heart palps?)... I tried nexium and all that stuff... nothing helps the palps.

I wore a heart monitor and confirmed that these really are palps or PVCs. But no explanation for WHY I am having these... it has turned my life upside down... cant sleep... canceled vacations...

One weird note... If I gulp air into my throat so that it gets trapped in my esophagus... the palps seem to lessen or even go away a bit...

any ideas?!?!

[Dorie777]

I've had this happen lots of times.  But these spasms only started AFTER I had RNY Gastric Bypass Surgery.  The first episode happened after I drank some Niquel.  I woke up and thought I was having a heart attack and my husband called 911.  After finding out my heart was fine, they did say I was extremely low on potassium.

I still have these attacks and it always happens after I have a food seasoned with ground red pepper and I love red pepper!

[Dorie777]

When I feel one coming on I can cut it short by taking small sips of fluid constantly until it passes.  If the spasm gets to far along, I have to endure the symptoms (in agony).  They are usually over in about five minutes if they get full blown.  It seems like hours though!

[Ozriel]

This advice may come a little late, but I wouldn't recommend doubling up on the acid reflux meds.  I bet it's the Aciphex that is causing palpitations and chest pain.  The second day I took Aciphex I could feel my heart pounding and cramping in my chest.  I couldn't find this listed as a side effect, so I stopped for a few days and it went away.  Every time I would begin taking it again this would happen, so I knew it wasn't just in my head. Stop taking the Aciphex! I need to find another medication that does not produce this side effect, which is why I came to this site wondering about Zantac.  Anyone else had this problem with Zantac (or H2 blockers) alone?

[SR7777]

yikes! This sounds similar to me and I am searching for answers today because I had a scope today and they found nothing but an inflamed breastbone which explains none of this. I often have heart palpitations and my attacks last hours usually. They happen shortly after eating but it doesn't seem to matter what I eat. I guess I am not suprised that the scope showed nothing since I fasted and so there was nothing in my stomach for them to see. I believe it is some sort of spasm and I can feel it in my throat. It feels like something is stuck there and sometimes it hurts. They had me taking prilosec twice a day and carafate liquid four times a day. It helps some but they told me today at the GI doc to quit taking it and go back to prilosec once per day and that just leads me back to miserable. Sometimes the attacks last several days and I can't sleep and am very uncomfortable. Sometimes burpring provides like a 1-2 second relief but it doesn't take it away. UGH! What test is done for an esophogal spasm? I need to get my doc on the right track. Thank you for any info you can provide

[bassman1]

after yrs of suffering and trips to ER thinking i was having a heart attack, a liver specialist in cincinnati came up with a combo of drugs that works for me (after months of trial and error).  my symptoms were so debilitating i was considering a fairly dangerous hiatal hernia operation which my liver doc thankfully  talked me out of. here it is:

RX strength nexium at 40 mg/day and nefidipine ER at 30mg/day and over the counter ranitidine 150 mg and famotidine 20 mg once in the morning. i often take the otc in the late afternoon if needed.  

i have had non-alcohol hepatitis c for decades and am aware of the nexium warning regarding use with liver disease.  every now and then i take a break from the nexium and double up on the otc meds.  i then have some mild symptoms that are manageable but only when i take a break from the nexium. otherwise NO symptoms.

[catk2822]

I just wanted to say that I have had all of these same symptoms for years.  The Dr.'s have not always been much help.  Especially because I had never had heartburn before in my entire life and was still not experiencing heartburn when the chest pain started.  I have had my heart tested more times than I can count.....always normal!  Very frustrating to not have answers.  Finally one day, I was rushed to the hospital because they thought I was having a heart attack.  I had pain in my chest, shoulder, neck and jaw.  It was hard to breathe and I was extremely nauseated.  The paramedics gave me Nitro, again thinking that it was a heart attack.  The Nitro actually helped but only for a short period of time and I would have to take it again.  To them it was confirming that it was my heart.  After hours spent in the ER, extremely drugged up and with many tests, they determined that my heart was fine but since the Nitro helped the symptoms, my problem was Esophageal spasms.  I did many tests and procedures with the GI Specialist who confirmed that my problem was Esophageal spasms.  Due to the fact, that I never have heartburn or acid reflux, the Prilosec and Prevacid meds do not help me.  They do not have any idea why I have these episodes.  The only relief that I have is the Nitro patch that I can use for the debilitating moments of pain.  However, the Nitro causes such severe headaches that I can only use it for a maximum of 2 hours, which is not always long enough to get me through the episode.  I can not take anti-depressants or anxiety meds and feel that I have been left with no real options.

Something that I have not heard anyone mention is abdominal pain.  I often have severe left-sided abdominal pain during the extreme episodes.  Dr.'s do not have any answers for this and no suggestions.  Does anyone have the left-side abdominal pain that seems to be associated with the Esophageal spasms?  And if so, have any suggestions?

I really appreciate not feeling alone in this one because the Dr's just don't get it and don't care.  They just throw their hands up and say "I don't know what to tell you!".  Very frustrating to say the least.  Always leave their office crying.  Just want help, understanding and relief.  As I am sure we all do.

[carlroberts1970]

Hope this helps anybody out there that hasn't thought about this before.
Basically I have the same symptons as you guys but I don’t have issues with swallowing or regurgitation or feel like food stuck in my throat....but I severely damaged nerves in my neck from a sports injury 18 months ago. So the following exert makes complete sense to me.

http://www.righthealth.com/topic/Esophageal_spasm

http://*****************/question/index?qid=20061008012324AAsjnpS

“Be aware of there being 2 nerves which enervate the esophagus - they must coordinate in their action to allow smooth passage of food or drink past that transitional area. If they are not in sync, you will have some distress..

There is treatment for it but meds will not have any effect on gaining the functional balance of this out of sync neurological disorder. There is direct interference with one of the nerves. Thus the pressure on that nerve must be determined and released. I am sure you will find a pretty sensitive area, at the base of the skull. Indicating some inflammatory process is involved, with those cranial nerves”.

BTW I still play football (UK football so I try to avoid heading the ball but inevitably do now & then) & play golf (twisting & turning my neck. So unless I give these sports up it seems i may always have the horrible oesophagael spasms.

Also after the initial injury & terrible bouts in bed of the spasms i had 5 sessions of acupuncture & neck massage - helped amazingly well but as said i just can't give up my sports !!

[mylife4]

I have been having these spasm feeling s in my Espohagus sice I had my first child I was 24 years old.  I first noticed I was having anxiety where I felt like I couldn't take a deep breath.  Then a few months later I was having a fluttering feeling in my chest specifically my heart felt like it was flip flopping around.  I then started to feel it like I could feel a spasm vibration through my esophagus!  It scared me I stopped in my tracks like what is going on.  It even made my feel a little weak afterwards.  I have been having this for 9 years now.  Anytime I am relaxed it happens.  The latest symptom I will be laying down in bed just falling a sleep & my body wakes me up almost like a pure panic feeling I sit straight up & my heart starts to race really fast like I just ran a marathon.  it scares me  so much I hate that feeling.  I am the mother of 4 kids & feel depressed everytime this stuff happens i'm so scared something bad is going to happen to me.  I too have went to the Doctors & have had 3 EKG"S Bloodwork, Echiochardiograms & have worn heart montitors.  They can't find the problem.  The Echiochardiogram found 2 small leaks around my heart vaulves but say that's normal.  NOT sure how that's normal.  One doctor said I have Esophagel spasms & a heart doctor said I have tachchardia & that it's not gonna kill me.  He said stay away from caffeine!  I do & I still have this problem.  I have twinges of pain in my heart too!  also I have constant backpain in between my shoulders where my heart would be on my back it's awful!!!!!!!!!!!

[patient915]

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[bumdie]

I went to the doc yesterday and was complaining about the problems going on in my chest, left side, stomach and back.  I am a survivor for 6 yrs now, I have aways as little girl had this quivering in my chest and stomach.  If I jumped to hard or moved too quickly they would happen.  I am 62 yrs old now and have had these to come on maybe once a year, but lately for the last 3 weeks, I have had feelings similar to all of the above responses.  I suffer with hypothyroidism and that pain in the butt messes up everything.  With the meds I have been given they were for diabetes, hypertension, low vitamin d, acid reflu, bladder not empting, blurred vision, and only God knows what else LOL.  I do not ake anything for diabetes it is controlled by my diet, I do take vitamn d, multi vitamin, and extra calcium and magnesm I was told yesterday to see a heart specialist, and my regular breast doctor WOW!! I did the research for old doc and gave all the info now the diagnosis was palpitations.  I have been helping myself with synthetic meds and herbal meds.  I truly believe that undiagnosed thyroid problems causes a lot of the problems I have.  When I missed two weeks of my Herbal thyroid assist the palpitations and spasms came.  I too had an accident and had neck and back problem but they have gone sense.  So take control and demand a test for your thyroid it controls the harmones, temps and even diabetes.  Pain in most of us is caused by inflammation and will cause your heart palpitations, and so many other things. Most tests does not detect a problem with the thyroid but there is one out there that does.  I know how each of you feel but different meds and herbs effect each of us differently.  I pray most of the time that helps all the time Isiah 53:5. I am only experiencing a little of the jumping and choking feeling in the throat.  After taking my thyroid assist an herbal med I feel better.  I had to take charge of my body so I only take a half pill 5mg of Bystolic BP med,  prescribed to help but I feel makes it worse.  Lord help us all!!!