Hiatal hernia- heart palpitations

[mao4]

I am 38 year old female. During each of my 4 pregnancies I violently vomited and was dehydrated.  I have never been the same. For 10 years I have experienced heart palpitations (pvc's), fluttering of my heart usually when rising, lifting, doing certain exercises.  For 5 years I have had "asthma" and use and inhaler 1 x a day.  For 5 years I have difficulty swallowing sometimes especially meat.  I have been treated for: Mitral valve prolapse, then it was later discovered I didn't truly have one, anxiety, asthma, bronchitis, etc. 14 days ago I choked while eating a piece of steak.  I could breathe but could not swallow, not even my own saliva.  I went to the emergency room after 7 hours of waiting to be seen I was sent to another hospital where a gastroenterologist put a camera down my esophagus.  The opening was 9mm? I was told the average was supposed to be 20.  The steak had gone down but he put a "balloon" and enlarged the esophogeal opening to 15.  He also did a biopsy and called later to say he found "Barrett's Esophagus" and it was benign.  Could I also have a Hiatal Hernia?  And is it possible that all these years this hernia has caused the arrythmias? Couldn't the hernia cause pressure in the chest cavity and cause the heart to skip a beat? By the way I have NOT USED THE INHALER ONCE!!!! and the continued pressure that I had felt in my chest is gone.  I do still have the PVC's.  thank you so much for your time.............suffered long enough!

[Kevin Pho, MD]

I am not aware of a direct connection between a hiatal hernia and PVCs.  It may be possible that the symptoms from the hernia may exacerbate the PVCs.  In order to evaluate the heart, I would suggest an echocardiogram to ensure there isn't any structural heart abnormalities.  I would also consider an event monitor - which can measure your heart rhythm to ensure there is no arrhythmia present during the symptommatic periods.  

A thyroid test should also be obtained.  If the PVCs become incapacitating, a referral to an electrophysiologist can be obtained for further evaluation and possible ablatement of the PVCs.

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.

[tessa0825]

You should call your GI Dr. and get more information than what you have already received..Barrett's esophagus is a pre-cancer lesion that will need routine surveillance by EGDs and biopsies...You need to ask him (the GI Doc.)if you have any dysplasia and if you do, ask if you have low-grade or high-grade, or if you hopefully, have metaplasia only...(Im not sure what he means by it being benign, barrett's esophagus is not a cancer, but it can become cancer, a very unkind adenocarcinoma of the esophagus).. The answer to that usually determines the frequnecy of your surveillance...There is a really good website that answers almost every question you could ever have about Barrett's esophagus..It is www.barrettsinfo.com...Be sure to check out the credentials when you first visit that site and you will find that it has been edited by some of the top Gastrointestinal specialists in the country, including Dr. Richter of CCF and Dr. Wang from Mayo....There is also a good online support board for barrett's esophagus patients sponsored by John Hopkins Univ. You can access it from their website...

Sometimes when you have a stricture it may be necessary to have it dilated more than one time. They areusually formed from scar tissue and are what causes the narrowing of the esophagus...Sometimes they are quite stubborn and may require several times to completely break through the scar...If you have painful swallowing again you should make sure to call your Dr. right away...

Did your Dr. tell you how important it is to follow the GERD diet? You should also sleep on a wedge or raise the head of your bed to keep the acid from refluxing into your esophagus while you are sleeping...BTW, Im certainly not an official anything here, Im just another pt. sharing some of the knowledge I have learned with this disease....

Best of luck,
Tessa

[ccq]

Though I have not been diagnosed, I believe I have a hiatal hernia, characterized by intermittent symptoms -- most notably occasional arrythmias.  I've lived with it for several years, and have decided there isn't much to be done about it.  It's not diagnosed, because I can't guarantee that the symptoms will occur when the ECG is being taken, or when I get an upper GI assessment.  I haven't done the Holter test, primarily because I haven't pressed my doctor on the issue.  Not many doctors seem willing to accept the possibility of a connection.

In my case, my heart will occasionally skip a beat, sometimes it will race, sometimes this will be accompanied by dizziness and difficulty breathing.  At first it was terrifying and I had no control over it.  In time I recognized that the symptoms always came when my stomach was gassy and that if I could clear my stomach of gas by burping, I would feel the pressure around my diaphragm decrease and the symptoms would go away.  It never fails.  If I can get a good burp out, the relief is immediate.  So I live with it.  Medicine is bound to be at a loss in a case like this -- the cardiologist and GI doctor just cannot get on the same page.  

My very limited advice is to stay calm and try to aim at the underlying cause.  From what I've read, if the arrhythmias are not related to underlying heart disease, they are not likely to be dangerous.  If a hiatal hernia is responsible, there are open and arthroscopic procedures that might help to correct the problem.  Otherwise, follow all the recommendations for managing gastrointestinal reflux.  I don't have reflux, but anything that reduces gas works for me -- primarily avoiding raw onions.

[tessa0825]

I also had alot of chest area pains and palps. Many times they would wake me up in the night...Im not sure if they know how GERD or a hernia effects heart symptoms but I know before you can assume they are GI related you should have your heart checked completely...I did and Im still not sure what was causing them...I was staretd on toprol XL but soon after I had esopahgeal surgery and some where in all that the palps have stopped so I dont know if it is due to the medication or the surgery....Its very scary to wake up and have your heart racing...I also take 120mg daily of bentyl and that has helped with GI spasms...Tessa

[mao4]

I also have woken up for years with a racing heart.  Sometimes I wake up so dizzy I have to lie there for 1 hour before I can actually stand up.  I have tried everything from not eating sugar for 3 years, waking up at 3am to eat a protein snack (thinking maybe I had low blood sugar). These did not help.  I wondered if anyone has actually been diagnosed with a hiatal hernia and how was it diagnosed.  Can they fix it.  Also I believe if I do have one it could have been caused by excessive vomiting during pregnancy, did anyone else have difficult pregnancies?  I have been thouroughly checked by a cardiologist.  I have had several EKG's and worn a Holter monitor 2 times. Sometimes I don't have the palps during the EKG.  But when the Dr had me squat and stand up quickly I had several palps which makes me think it could be the pressure of a hernia restricting my heart.  I also don't think the drs want to connect these symptoms.

[tessa0825]

Yes, I had a hiatal hernia, it was diagnosed during EGDs, manometry, and barium swallows..It was corrected during the surgery I had last year..I had gastroplasty and fundoplication with hernia repair..Almost everyone that has reflux surgery gets a hernia repair...

[subpar]

After reading quite a few comments on this thread and others I am with you all in saying that PVC's and espophagus problems, GERD symptoms are very much related at least on my case. I have had chest pain, skipping beats, and even an a-fib episode (shocked out of it) in 1997. Since 1997 up to now I have had many heart related tests (echocardiogram, stress tests (2) and several visits to the cardiologists. He has said my heart is fine, no problems at all, yes I have PVC's (carried around an "event monitor") but no meds, every thing is fine according to him. But the symptoms NEVER went away. In 2000 I had an EGD??. All was fine, I had a 24 hour PH test, all was fine.....they implied I was/am nuts. Anyway the symptoms NEVER went away, I too woudl wake up in the night with racing heart or even a abnormal beating heart, I called 911 twice, by the time I get to a hospital, me heart has straightened out. Well now I feel like I am gagging all the time. I had a barium swallow test just a month ago. The found a Schatzky's ring and did another EGD to dilate. Anyway I am still gagging and choking ALL the time--it is extremely unomfortable--it hurst a lot. My gagging seems to be in my upper throat or esophagus, the "ring" they found was "distal". Whatever they did gave me no relief. Eating wears me out, feels like I have TMJ as well, who the heck knows?? Anyway I have no idea what to do. I have had all the tests but I am not crazy. Talking some times gets tough too---I can gag with nothing in my stomach or with something--eating some times makse my pain worse....any ideas??? I am 47, white male, and yes my doctor told me to take prilosec OTC twice a day. Thanks for any input!! Subpar

[Ling]

I found my way here because I have been worked up by a cardiologist for PVC's.  I have pain and bloating in the upper abdomin (abdomen) and I too get short of breath.  If I can belch I feel so much better.  Even though I still have the PVC's.  What I notice seems to be a bubbling in my upper stomach on the left side and gas.  If I sit straight up I can burp to relieve pressure.  If I stay slouched and try to burp, all that comes up it food.  

My doctor wants me to schedule and endoscopy.  She says there is mild sedation.  Does this hurt?

[tuff case]

The Upper Endoscopy(EGD)will not hurt I have 3 of them done  a couple fo years a part from each other.  You are basically put to sleep and wake up in recovery the only thing you may have afterwards is a little scratchy throat from the tube that they put done your throat.  This may last a couple of days but that is all.  You should always feel comfortable with the Dr. that will be preforming the procedure.  The more comfortable you are with the dr. performing the procedure the more comfortable you might feel about the procedure also.  Be sure to ask your Dr. about any questions you might have before either scheduling or even while you are there before they sedate you let the nurses know you want to speak to the Dr.  You can go on line also and find out information about what happens during the procedure and what it can be disgnose from it.  I hope I have helped you.  Good luck!  Where are you located? TC

[Lakeman]

Just adding myself to the people frustrated from PVCs and gastro problems that the doctors refuse to connect.  In my case, I started getting PVCs (or so they seem) last October 10th.  After waiting for them to go away and the didn't, I went to my internist.  Did a Holter that showed many abnormal beats and he said it was normal (?).  Referred me to cardiologist for echo cardiogram and stress test.  Passed both - I am a runner (15 miles a week).  Said I have the heart of a 30 year old (I am 58).  Went to a heart electrical specialist he said no detectible problem without doing any other tests.  All the time, stomach gas seems often to come with the PVCs.  Now my stomach will churn and growl for hours and hours along with some pain in upper abdomin (abdomen).  I am now scheduled for a colonoscopy but I have little hope.  Is there any "acceptible range" for the frequency of abnormal heart beats?  I often run in the 150 abnormal beats per hour range, doesn't seem normal to me.  Also seem to be happening more frequently.

Any ideas?

[Lakeman]

Just adding myself to the people frustrated from PVCs and gastro problems that the doctors refuse to connect.  In my case, I started getting PVCs (or so they seem) last October 10th.  After waiting for them to go away and the didn't, I went to my internist.  Did a Holter that showed many abnormal beats and he said it was normal (?).  Referred me to cardiologist for echo cardiogram and stress test.  Passed both - I am a runner (15 miles a week).  Said I have the heart of a 30 year old (I am 58).  Went to a heart electrical specialist he said no detectible problem without doing any other tests.  All the time, stomach gas seems often to come with the PVCs.  Now my stomach will churn and growl for hours and hours along with some pain in upper abdomin (abdomen).  I am now scheduled for a colonoscopy but I have little hope.  Is there any "acceptible range" for the frequency of abnormal heart beats?  I often run in the 150 abnormal beats per hour range, doesn't seem normal to me.  Also seem to be happening more frequently.

Any ideas?

[denise45]

A related discussion, plapitations was started.