25M, Mobitz Type 1, GE Sufferer Seeking Information

[Paul-N-Vilevac]

  Sirs;
  I am a 25 year old male, former military, 5'8", 160#, excercises infrequently, formerly trained heavily for distance running.
  At age 4 I was diagnosed with ASTHMA and treated with Alupent and the Theophiline Theo-Dur.  Attacks were infrequent, but did require hospitalization.
  1 year ago I began taking Claritin for allergies.  Within 3 months I began suffering extreme anxiety attacks, as well as chemical sensitivities to caffeine.
  I stopped taking Claritin after 3 months.  Was placed on Allegra.  Anxiety attacks returned.
  3 months ago I started to suffer from stomach distress, mainly adominal (abdominal) bloating, burning after eating, which tended not to be affected by laying down.  Frquently at night I felt as though I suffered from trapped gas in the up GI tract, with difficulty relieving it.  
  On nights when I felt as though I had gas pressure in my mid esophageal tract, I would tend to drop heart beats.  Additionally, I have occassionally had difficulty competing a swallow (food plug seeming to stop near the diaphragm, until it was either forced to pass (by forcibly drinking) or vomitted back up.  Size was not an issue.
  Additionally, I have suffered from an odd attack.  I awake, being able to inhale, but barely able to exhale (from the chest).  Drinking seems to clear the blockage.
  I have been suffering stomach discomfort, gas, bloating, pain lately.  I have tried tagamet, pepcid, and lately Zantac.  Zantacs seems to help when taken.
  Within the past 2 - 3 months, though, I have become more and more aware of dropped heartbeats.  EKG reveals both a 1st AV Node Block and 2nd AV Node Block (Wenkebach).
  I am currently seeing a Cardiologist, I have had a halter and am awaiting its findings.  I will be going in for an echocardiogram this week.
  I am curious if I should also attempt to see an Gastroenterologist for the stomach problems.
  Finally, I have been suffering periodic fasciulations in my forearms, wrists, knees, and shoulders.  I am unsure if fascics are muscle / ligament of vein / artery related.  Usually when I have what appears to be a fascic, it appears as if a vein where hopping up and down.  Should I mention this the cardiologist, GE, or maybe a neurologist?
  I don't mean to sound like I am falling apart.  I just want to feel well, and I don't currently.
  If anyone has resources I should read, please post.
  Thanks,
  Paul

[CCF Cardio MD - MTR]

Dear Paul, thank you for your question.  I'll address each problem individually.
1) GI Problems:  The symptoms you describe sound to me like gastroesophageal reflux or abnormalities with esophageal muscle contraction.  Reflux is commonly treated with medications like tagamet or zantac, but I suspect you have been taking the over-the-counter form of these medications, which is too small of a dose to be effective.  Alternatively, there are two prescription medications (prilosec and prevacid) that almost completely block stomach acid secretion - these medications may help you.  Finally, there is a medication called propulsid that improves emptying of the stomach and may help with the problems you have with swallowing.  For this constellation of symptoms, you should see a gastroenterologist.  I don't think these symptoms are related to your heart.
2) Muscle Fasciculation's:  Without witnessing the fasciculations, I can't comment on whether they truly are present and on what the cause could be.  Your internist should be able to look into this problem.
3) Cardiac Rhythm Disturbances: If your ECG did show 1st Degree AV block and Wenkebach 2nd Degree AV block, don't worry.  These conditions are benign and do not indicate that you will need a pacemaker or that you have serious cardiac disease.  With Wenkebach, you may feel occasional "dropped" heartbeats.  Both a Holter Monitor and an echocardiogram are appropriate tests for you, which will probably confirm what the ECG showed.  You mentioned that you used to training for distance running and that you don't exercise much now.  I strongly recommend that you start an exercise program again - you should notice many positive benefits for your health and that some of these problems may lessen or disappear.
I hope you find this information useful.  I'd also suggest that you speak to your cardiologist after your tests are done to get a final diagnosis and prognosis.  Information provided in the heart forum is for general purposes only.  Your physician can only provide specific diagnoses and therapies.