Esophageal Dysmotility?

[arthur]

For about six months now I have had arrhythmias (PACs) to varying degrees that seem to be associated with a curious "vibration" running through the center of my chest.  These tremors/vibrations are clearly separable from the arrhythmia symptoms, since the PACs disappear when I assume a horizontal position, but the vibrations continue.  Cardiological assessment (ECG, stress echo, nuclear stress, Holter, etc) indicates a healthy cardiovascular system.  A recent endoscopy indicates mild reflux irritation (more details forthcoming pending next office visit). In addition, I have symptoms of globus (hystericus) with occassional heartburn...for which I have been prescribed Prevacid (which after a few weeks seems to have ameliorated the globus and to some degree, the intensity of the "vibrations").

I am an avid soccer player (52 years old), whose resting heart rate (40-50 bpm) and somewhat enlarged heart are characteristic of years of intense exercise.  The cardiologist feels the atrial/pulmonary vein juncture may be over sensitized due to over-training (thus the PACs).  

My questions:
(1) Can esophageal dysmotility of some kind be afoot, ie, is it possible for the smooth muscle system surrounding the esophagus to undulate/vibrate, and if so,
(2) what can be done to control this unwanted movement?  
(3) If you care to speculate, do you think it's possible for such esophageal undulations to impart pulsating pressure on the heart (especially an enlarged and sensitized heart) and precipitate arrhythmias?

Your response is eagerly awaited.  I realize that your forum is designed for information exchange and not speculation, but any suggestions regarding question 3 would be very appreciated.

Thanks,

Arthur

[bgb566]

A related discussion, Interested in finding out about upper pulsating in esophagus area felt when laying down, but then subsides. was started.

[DeidraInez]

A related discussion, Esophageal Vibrations was started.

[GIGI]

Hi Arthur any luck finding out what is causing the vibration or undulating sensation you thought might be related to the esophagis?  I ask because I experience the same type of sensation which has become steadily more intense over a five year period.  I'm not having much luck finding answers.  For me its a constant undulating movement or spasm that goes right through me back and front from the gut/spine area to the top of the head.  Is aggravated be eating and when in a horizontal position.  Wakes me up at night.  I'm working with a medical  oestopath who thinks it is muscular/skeletol but not really getting any results.  I don't appear to have any cardio, neuro or obvious gut/gastro problems, all tests come back A.O.K.  I'd certianly like to find out what's doing this.

Gigi

[GIGI]

Arthur just browsing this Q.& A. Forum when I spotted your query. I too have this 'vibration' you are referring to: strong undulating movement going down my centre from head, back of left nostril down to gut area.  Is much worse after I eat and also when I am lying down.  Started of as a 'bit of a vibration'; now it is a remarkably strong 'spasming' sensation with acidy burning from stomach to throat; having flow-on effects elsewhere but I won't go into them. Convinced it is the esophagus and medico's agree but seem to think there is little that can be done about it except try to keep the acid down, (had endoscopy which revealed bad case of H.Pylori,supposedly eradicated, but nothing else). If anybody reading this can throw light on the subject I would be exceedingly grateful as I am at the end of my tether and can't cope with this much longer.
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[HFHSm.D.-Gastro-rf]

Dear Arthur,
Patients with esophageal dysmotility may have chest pain but vibration or undulation severe enough to cause a nonpainful sensation would be unusual.  In fact, I am uncertain what chest condition could even cause the symptom.  I think that it would be unlikely for the esophagus to impart pulsating pressure on the heart.  Pressures associated with esophageal contractions are much lower than the pressures associated with cardiac contractions.

[Peter]

Hi Arthur!  After reading your story I believe I share a similar problem with my esophagus and heart arrhytmias.  I will not go into much detail here but I will say that for the past eight years I have had atrial arrhythmias that are 100% associated with the esophagus and the action of swallowing.  So far  doctors  have  acknowledged the problem but cannot isolate any mechanism (it seems this mechanism is a relatively new and unresearched thing).   I am now 39 and in otherwise perfect health.  I too have led an extremely active lifestyle, competing at 5 national championships, run marathons, mountain climb and whitewater kayak.  This problem generally came out of nowhere and has kept me searching for answers.  I also have a large heart, probably due to a lifetime of heavy training.  The atrial/pulmonary vein junction is an interesting idea.  If you would like to discuss this further my email address is:
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Good luck!
Peter

[Carolyn]

I HAVE FREQ PROBLEMS WITH SWALLOWING AND HAS RESULTED IN WEIGHT
LOSE OF 30 LBS SINCE APRIL OF 1999. I HAVE REQUIRED 3 HOSPITAL VISITS BECAUSE OF ELECTLYES IMBALANCE AND LOW K.
MY TEST SHOW DYSPHAGIA. I HAVE CHEST PAIN AND REFLEX VOMITING OF
SOLIDS AND LIQS BUT LIQS ARE WORSE. SOME TIMES NOTHING WILL GO DOWN REGARDLESS OF WHAT IT IS.
THEY KEEP CALLING IT ACHELISA BUT MY TEST DON'T PROVE THAT
WHAT IS ACHELISA ANYWAY?
THANK YOU FOR ANY HELP YOU CAN PROVIDE.