Concurrent onset of CHF and intense GI pain

Hello:

About 12 years ago my mother was diagnosed with Tachy-Brady, and an idiopathic cardiomyopathy. Amout 10 years ago my mother passed out while on a plane and had a pacemaker implanted shortly thereafter.

My mother is now 70 years of age, and is taking cumiden, premproto, vasotec, digoxin, aldactone, k-tabs (for a potasium deficiency) asiphex and furosemide (80 mg).

About 3 weeks ago she complaned of intense gastric distress, vomiting, and shortness of breath. We also later noticed swelling in her feet. She was then diagnosed with CHF after having a chest x-ray.

After the diagnosis of CHF, she was just taken off cardizem CD and given diauretics.

For a few days she felt much better and was even able to eat a full Thanksgiving meal. Her swelling was considerably reduced.

However, several days later the intense GI pain returned. Also around this time, her cardiologist had her begin taking Coreg as a replacement for the Cardizem CD.

She describes the GI pain as an overwhelming feeling of pressure and fullness, causing her to frequently burp. The pain is so intense she cannot even sleep, and i am very concerrned for her.

After hearing of her pain her Cardiologist took her off Coreg last week and is putting her back on the Cardizem. To further complicate matters, she went into atrial fibrulation two days ago which convinced her cardiologist to cancel an endoscopy which was scheduled after she had seen a gastrointerologist.

As of today (Monday) her heart is back in her normal pacemaker induced pattern and her GI pain has lessened slightly but she is still suffering quite a bit.

Can you shed any light on what might be causing this and is there anything that might be done to releive her symptoms?
What cause of action should we take?

Thank you for your help and this wonderful service.

Ian

[CCF CARDIO MD JMF]

Dear Ian,

The GI tract is directly linked to the heart via the liver and the circulation to the GI organs.

With CHF fluid may back up into the liver and cause hepatic congestion.  OFten this gives one a feeling of fullness.  

Further, if your mothers heart failure is on the basis of ischemia or lack of blood flow, she may also have a relative decrease blood flow to certain areas of her stomach and bowel causing these  symptoms.  Both these entities should be evaluated by her physician.