Gall bladder, acid reflux and chest pain

[tigger04]

I'm a 40 yo female. Otherwise healthy, I was diagnosed this past Sept. with both gallstones and Wolff-Parkinson-White syndrome. I was VERY symptomatic and so I saw an EP in January '04 and had an RF catheter ablation for WPW and AVNRT. Had mild chest pain, extreme fatigue & extra beats for 6 wks afterwards. At the follow-up, the EP seemed to think that I should go on low-dose Atenolol for some ventricular beats that showed up on an event monitor. He never addressed the chest pain, ongoing fatigue or breathing problems.  Before you think I'm sending this to the wrong forum (!), here's where things get GI-oriented.



I had a major episode of burning pain, ctr of chest, clavicle level 1 wk ago. No dizziness, no arrhythmia, no numbness at time, but did have acidic taste in my throat & weird "consciousness" of my esophagus. Since I have low bad cholesterol, hi good cholesterol, lo normal blood pressure, and no family history of CAD, cardio thinks there's good possibility of my having either acid reflux or a coronary artery spasm. He has sched'd nuclear treadmill,echocardio,chest x-ray, & follow-up w/EP to ensure that there isn't a cardio reason for my symptoms. (Have had ongoing chest heaviness and discomfort, shortness/oddness to breathing a good deal of the time since ablation but not pre-ablation.)



Here are my questions:

1) Previously diagnosed w/LOTS of gallstones & know I need g bladder removed; haven't done so b/c of the arrhythmia diagnosis at same time. Could gallbladder be causing a burning high chest pain without assoc'd backpain, pain or other symptoms I exper'd when I had 1 previous gallb attack? (My burning chest pain lasted 20 mins, then gone.)

2) Can a person my age w/out any history of heartburn or other GI distress suddenly develop acid reflux?

3) Is it true that there are nerves (the vagas?) assoc'd w/both arrhythmias & acid reflux?

4) Is it possible the ablation could have damaged nerves or other mechanisms that now are causing the acid reflux?

5) Is acid reflux assoc'd w/sudden onset of extremely intense burning pain, very localized to the center of the chest, clavicle level . . . with no other symptoms or obvious antecedents?

6) Could being on enteric-coated aspirin (325mg/1X day) for 6 wks have generated any GI problems that might cause the chest pain and maybe even episodes of altered breathing?

7) My cardio MD has not yet sent me to a GI specialist and instead, prescribed NEXIUM to see if my chest pain goes away. GIven he has also simult'ly put me on Cardizem and an enzyme (L-Arginine), I am puzzled to know if there is not a test that a GI doc could do to actually diagnose whether I'm having acid reflux rather than use an "uncontrolled experiment" of treating it w/NEXIUM and determining the diagnosis based on whether I improve or not. Maybe that would be a good idea if I was only going to be taking that one medication, but he has me on three!



Thank you very much!

Tigger04

[Kevin Pho, MD]

To answer your questions:

1) Yes, it is possible for the gall bladder to present with those symptoms.



2) Yes, it is possible that acid reflux may appear without a prior history.



3) I am not aware of a direct connection, however it may be possible that the heartburn may trigger any arrhythmia.



4) I am not aware of an ablation damging nerves that may lead to an increased incidence of gastric reflux.



5) Yes, acid reflux may be associated with the symptoms you have described.



6) Aspirin may be associated with inflammation or an ulcer of the upper digestive tract.  You may want to consider an upper endoscopy for further evaluation.



7) A 24-hr pH study is the most comprehensive test to evaluate GERD.  This can be discussed with your gastroenterologist.  



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.



Thanks,

Kevin, M.D.

[yoshi]

if you can get hold of a copy of illustration inside the zantac package(which is over the counter medication to treat heart burn),there is a drawing of a man with the acid reflux problem rising to his chest.

yes,that stomach gas can rise up thru the esophagus and give you a strange taste in your mouth,it will also erode the enamel of your teeth.



acid reflux problem does not go away by itself,it just get worse if left untreated.

read some of the threads on this forum and search the webs for articles on GERD or acid reflux or hiatal hernia,plenty of good info to read.