For the past 10 years, I've experienced worsening symptoms immediately after meals: rapid, strong palpitations (recorded on Holter and said to be fast, i.e, 90-100 BPM but benign); fatigue; and sometimes diarriah.
I'm thin, and have become much thinner of late. I've slowly given up foods associated with the symptoms, including wine, desserts, and high-carbs. I avoid restaurant food and frankly am at the point where I hate to eat! I weigh 109 pounds, (female, 5'6).
I do have cardiomyopathy without LV failure and take several medications to prevent CHF, including lisinopril, eplerenone, ranexa. I've also had a biopsy to confirm microscopic colitis.
My bloodwork is normal for diabetes and endocrine disorders.
What could be causing the symptoms and what should my next steps be?
Not aware of specific GI diseases that can lead to a rapid heart rate. Thus, at this time I'll focus on cardiac causes.
With the diagnosis of cardiomyopathy, I assume an echocardiogram has already been done. I would consider a stress test to see if the palpitations can be replicated in a controlled setting, as well as an event monitor to exclude arrhythmias.
A referral to a cardiologist should be considered to discuss these testing options. If an irregular heart beat is found, an electrophysiology referral can be considered.
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 Pho, M.D.
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