Ectopics & GERD

[Agusto]

I have an endoscopically proven hiatus hernia. Also mild angina. Exercise EKG was positive so  I had an angiogram - 20% blockage of right coronary (unchanged between 2 angiograms three years apart).
Current problem for past few months is atypical chest pain and ectopics.
I can get chest pain which is definitely due to GERD, and a different pain which is anginal. But I also have been getting a severe burning pain which spreads across all of my chest and to both arms which does not fit with either. This usually starts at night and wakes me up. Use of antacids or GTN has not convincingly relieved the pain - usually settles after 15 - 20 minutes regardless of what I do. Three times I have heeded standard advice and called ambulance - EKGs and bloods have always been negative. I therefore now put up with it until it eases though this leads to an hour of anxiety for both my wife and myself!
For past month, the hiatus hernia has been troublesome and I have started getting several bouts of ectopics a day. During last admission these were seen to be ventricular ectopics. They vary from 1:1 beats to perhaps 1:5. They occur a few times a day and last for 30 seconds to 2 minutes. Usually triggered by change of position - e.g. bending.
I believe my problems are mainly due GERD and as such I now try and ignore them.
But can there be a relationship between anginal pain and GERD and can the latter also be responsible for runs of ventricular ectopics?
Therapy includes atenolol and lansoprazole.

[Michael J. McWilliams, M.D.]

I have heard many patients suggest that their PVCs increase after meal time.  Chest pain or burning chest pain related to GERD is often after meals, especially when you are lying flat.  It is impossible to say that the GERD is definitely causing the PVCs, but is possible.  I agree they can cause significant symptoms, but in general the prognosis is very good.

I hope this helps.