Reflux Esoph/Palpitations

[Art S.]

In February of 2004, I experienced my first bout with palpitations. Over the next 15 months, I had numerous tests (echo, holter, stress echo) and though I have pvc's and pac's, the tests were clear as far as more serious heart problems are concerned. Blood flow is good. Normal size heart. I exercise regularly. Non smoker. The cardio folks have me convinced I have no problem there, but symptoms continue. During my last visit with the doctor (first visit with a new cardiologist after a change) he indicated that he thought I had acute reflux esophogitis. I have significant belching (particularly while exercising), pressure in the chest, light headedness and the sensation of "buzzing" (for want of a better phrase) in the abdomen and head. My heart beat is very noticeable and the pressure in my chest turns into out and out pain irregularly. I have been on protonix, which dosage was doubled a week ago. The symptoms are continuing and I am just about tired of it. I am able to exercise with no shortness of breath. I am generally sleeping well. I have lost weight recently on a 2K diet (went from 270 to 232 and expect to be able to level off at 215 - I am tall 6'3" with a large frame and my percent body fat after a recent test was 16.04%)

I am tired of not feeling good and feel like I could kick the world in the pants if I could just whip these symptoms, which have been particularly bad since February of this year.

Questions:
a) Does this sound like reflux esophagitis?
b) Can RE cause palpitations?
c) Would you visit a gastro doc or other specialist at this stage?

Thanks very much for helping.

Art S.

[Kevin Pho, MD]

To answer your questions:
1) It is certainly possible that your symptoms can be caused by reflux.
2) I am not aware of a specific connection betweem reflux and palpitations.  To further pin down the diagnosis you can consider an event monitor - which can specifically record the heart rhythm at the time of the symptoms.  Another option would be to consider a 24-hr pH study which is the definitive test for GERD.  If the Protonix is not doing the job, surgical or endoscopic treatments should be considered.
3) At this time I would consider a GI evaluation to determine if GERD is causing your symptoms and to optimize treatment.

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

[marburg]

Hi Art,

The archives have a lot of posts related to the Palpitations and Reflux.  I also have had echo, holter, stress tests, ekg, etc.  Everything always turns out to be be basically normal.  Recently I've noticed that my heart has been beating noticeably rapidly, sometimes there is chest pain and sometimes I've had rapid shallow breathing.  My blood workup always shows normal but a little acidic (acidosis).  My doctor told me the heart beats more rapidly as it tries to lower acids and CO2 levels.  

What changes have occurred in my life?  I've recently started an exercise regime (treadmill, stationary bike, leg and back extensions, leg crunches and curls, upper cariod workout)resulting in a 5 pound loss in 3 weeks.  From what I've read the exercise could be causing lactic acid breakdown and CO2 buildup (which can cause Palpitations) even though everything in the blood workups have been normal. Then, I noticed that shortly after this (rapid heartbeat and changes in breathing) occurs I start burping and have the symptoms of Reflux.  Everytime I've had this, it has been acid reflux due to stress (in my case there has been personal and professional stress).  I too, would be interested in hearing responses from other folks who might have similar conditions or symptoms.

[MinnieM]

Yes, my doctor said that there are folks that have expereinced palpitations right after eating. I have this daily and do not like it.  I also have heart disease (misdiagnosed for years as all gerd related) But, I have grade 2 Gerd/Reflux and at times I need a dilation which can be done during the EGD. But, I was told that these palps after eating can come with a normal heart.

Good Luck To You.

[Art S.]

Thanks for the answer and the comments. Went to see the GI doc yesterday and it went well. Since the protonix hasn't knocked out the symptoms completely, he is going to do the scope next Wed and he changed medicines to Aciphex.

For those of you with RE, did you get to a stage where the medicine cured the symptoms completely? I understand that we're each different, but what should my expectations be? I have been fighting palps and RE related symptoms for a year and a half now, and I haven't felt 100% in so long I've forgotten what that feels like.

Art S.

[Inanga]

i had had palpitations off an on for years. I also had chronic hyperventilation syndrome. Basically chest breathing and not using the diaphragm properly. Since leaning to breathe properly with a pysio I have very few palpitation. If they do occur I then remember to breathe properly and they go away. my breathing specialist says poor breathing technique can cause palpitations and my expereicnce seems to back this up.
all the best.

[dmbcer]

I have had pvcs everyday for months.  They were driving me crazy. I knew they had something to do with digestion but I couldn't figure it out.  Then I came across some information about low carb diets.  I began the diet on the 12th of June and June the 13th was the last time I had any pvcs. For me it's not all carbs.  Only the starchy carbs. Bread, rice, potatoes, etc. It has been a blessing for me.  It is such a relief not to have that constant pounding in my chest.  If you look up "pvcs and low carb diets" you can find a lot of information.  Good luck and I pray that this works for everyone who suffers from pvcs.