Heart palpitations and GERD

Well, since my doc is pretty much clueless thought I would post this here. Has anyone ever thought that they had heart palpitations that turned out to be GERD related? None of these are caught on monitor, heart has checked out fine... I do get the chest pain and occasional reflux back up into my mouth...eeeew gross.

if you've had a full CV work-up ... there is a phenomenon known as atypical GERD.  it causes a symptom known as non-cardiac chest pain in which patients present with very similar symptoms as those who are having a heart attack.

I've had the ECHO, many many EKG's...not sure what a SED rate is..but have had hearts labs drawn in ER and they all came back fine. The docs all say that I have no "skipped beats" and I may have a few extra systoles...but don't even know if that is what I feel...or some strange GERD symptom.
Whatever it is...it seems related to eating, and movement. I've leaned back into my chair and had one, leaned foward to type and had one, reached for something and had one.
Sometimes I wonder if its not trapped gas somewhere in my chest...though haven't found any information on that to support it.
My doc is kindof dropping the ball I think...pat me on the head, tell me there's nothing he can do for the fibromyalgia and pain that I have, I'm perfectly healthy otherwise, and tell me to come back in a few months.
Sigh.
-Sarah

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HI Sarah,
I can relate so much to your symptoms. First of all, can you ever feel them in your pulse? I get PVC's (premature ventricular contractions), and can catch them on my wrist pulse site. If you get a premature beat, then your heart pauses a little longer for the next one. Since your heart has had longer to wait to fill on that following beat, it delivers a bigger contraction......and that's what feels like the thump in your chest.
Please read some of the other posts about fluttering in the chest. Some of us have that "small animal living in your chest sensation" that can sometimes feel like an irregular beat. But..........last year, I started getting tons of irregular beats. The would happen as soon as I'd start eating something, or they would really flare up by doing alot of work that required bending over.

Once I had so many, I went to the ER. The EKG and enzymes were normal. The doc gave me Magnesium by IV, saying that our magnesium level IN the cells can be low, and it doesn't show up on the lab test. So I would encourage you to take 200-400mg of Magnesium a day, and eat foods rich in magnesium. Our muscles become fatigued when our magnesium is low, and our hearts and intestines, among alot of other organs, are muscles. I also had a stress echo, which was normal.

Okay.....that being said, I have struggled with this irregular heart beat for awhile. How old are you? I'm 55, and found that I get alot of them from hormone fluctuations, going through menopause. But.......I'm becoming convinced that there must be some nerves in our esophogus that, when irritated, can cause irregular heartbeats. It's happened to me so many times! When I have a GERD flare-up, I have these irregular heartbeats alot more often. And I can relate to all the doctors not having a clue about this possibility..........but I'm sure it's happening.
Have you had a stress echo? Those don't completely rule out a heart problem, but they are a good start.

I also think that I might have a sliding hiatal hernia, and feel that when it is too high up in my chest, the pressure irritates my heart, and I have more irregular beats. Also, when I'm bloated and my GI tract is pressing against my diaphragm, I get those beats also. I think our hearts are very sensitive to anything pushing on them. My cardiologist did tell me once that people can have position-related PVCs.........they can have alot of irregular beats while lying on one side and not the other.

So..........make sure you've had your heart checked out completely, take magnesium supplements, drink lots of water, and try to control your GERD, and hopefully these very disconcerting irregular beats will slow down for you. I know they can be very scary, but my cardiologist assures me that when your tests are negative, these beats are totally harmless. He said some people have tons of them and don't feel them, while others of us feel every single one.

I'm relieved to hear that other people are making this connection with GERD, because I was positive my irregular beats were related to my lower esophogus, but nobody seemed to agree. Good luck to you!

Hi Sarah,
I have had this happen in the past. It happens infrequently for me, but again, I have been experiencing palp for yrs. Dr.s were never able to tell me the direct source.

Sarah, you are brave, a Dr Pepper & a chicken sandwich from McDonalds w/fries would have sent me running to the ER for a cocktail. LOL I wouldn't be surprised if the Dr Pepper was a big culprit w/all the caffeine, and the McDonalds chicken sandwiches are far to spicey for me(grilled or fried). Too much pepper. I love(LOVE)McDonalds fries, but definately causes problems for me. I will still sometimes sneek a few, they are hard to always resist. LOL

Just my two cents, chat w/you later!

Vanessa

I agree Vanessa,
I forgot to mention above that one of the worst culprits is pop. I started drinking 1 coke a day about a year ago for energy (since I have chronic fatigue), and maybe it's finally catching up with me. It's bad on the GERD and the irregular heartbeats. Caffeine can really increase them in people who seem seem to have them. Too bad it's so addicting! I'm struggling with trying to find something to drink that doesn't give me reflux, since water seems to do it too.

Hi,
Sounds reasonable that the caffeine may be the culprit for palpitations.

Some thoughts on pop and GERD.
This text is mostly excerpted from my book:
A recent study presented at the Digestive Disease Week conference in New Orleans Louisiana in May 2004, found a strong correlation between the rise in per capita consumption of carbonated soft drinks in the past 20 years and the increasing rates of esophageal cancer in the United States. The study proposes that there is a biological basis to explain the increased duration of esophageal exposure to acid as the consumption of carbonated soft drinks increases. The rational proposed is that carbonated soft drinks are related to gastric distension, which can trigger reflux. They are saying that the carbonation in pop is causing reflux.

I accept their connection between pop and reflux but don’t believe they fully understood the basis for their conclusions. My theory clearly assigns microbially produced gas (not only the CO2 gas from carbonated beverages in the stomach) as the main cause of acid reflux. My own heartburn disappeared after I reduced my intake of carbohydrates, yet I continued consuming carbonated beverages at the same rate, both before and after reducing my carb intake. The only difference is that I always drank diet soda exclusively, both before and after starting low carb dieting. This suggests to me that the carbonation in soft drinks is not the cause of acid reflux. Currently, on my reduced carb diet, I still belch after a diet soda, but the heartburn is gone. Interestingly, most carbonated beverages are loaded with the worst form of carbohydrate, simple sugars. I believe it is the intestinal gas produced by microorganisms feeding on the sugar in most carbonated beverages that drives acid reflux by pushing duodenal contents and stomach contents past the lower esophageal sphincter into the esophagus. If the sugar in carbonated beverages is the culprit and responsible for the rise in esophageal cancer, then one would expect the same level of risk consuming any foods containing excess sugars. That means drinking milk (containing lactose) or fruit juice (containing fructose) could also put people at risk for esophageal cancer. According to my theory, there is a connection between acid reflux and consuming excess carbohydrates in general. If follows that reducing carbohydrates in general may help prevent esophageal cancer. I believe my book is the first to propose this connection. To me, this makes rational sense.

Dr. Norm

 Hi to all,  CathyA I didnt know I had so many twins running around untill I came to the forum. You think that you are the only one with the problems and then you find out you are not alone. You sound just like me. I thought that my doctor was just telling me the same things your told me to keep me from asking too many questions   Wow  we all have almost the same symptoms. Yes my cardo has me take MAG same dose  also. I take instead of heart pills for my pvcs I used to take inderal for them but my heart beats slow anyway & they slow your rate down. I never payed my stomach trouble too much attention. I know that I love V-8 juice cant drink it nothing with tomatoes in it Yes Water gives me heartburnat times. But now my heartburn is getting worse.   You are lucky yourDr takes time with you my Dr sounds like SARAS  I ve been told the same thing she has. My doctor say to worry when I cant feel the off beats. My doctors nurse told me the last time that I am the only Patient they have that can feel the off beats like I do. Ive had them for 20 yrs or more. The gerd for 5yrs. Sometimrs its hard to tell which one is causeing the pain when they both are acting up. I know if I eat a big meal I get skipped beats. I am a big pop drinker about 1 litter a day. But now I mix it with water to cut down . I drink cola & ginger ale. I never knew that peppermint was bad for me. Since I quit smokeing last year I still have bad craveings so I eat a lot of sweets,AND JUNK Icant help it. I am gonna try to limmit my carbs.Is their anything that dont have them in it? Imean anything that tastes GOOD!  Well thanks for helping me answer some questions  Pat

Wow, I didn't know there was a connection between soft drinks and esophageal cancer. Dr. Norm, my husband and many others are just like you when consuming soft drinks. I exp reflux & palp problems w/carbonated drinks.

Cathy, you are not alone in water and reflux. I have spoken to many people who exp the same problem. Weird! Good luck with finding a drink w/o problems. I usually only drink water, occasionally, gatorade if my sugar level appears low. I don't have diabetes but sometimes feel low, probably result of drinking only water.

Vanessa

Hi Dr. Norm!

Hi all!

I was wondering if anyone had any feedback on my earlier post?

Wishing you all the best!
Hugs, Teri :)

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"Because he is he and I am I."......E. V. Lucas

Teri,
I had responed to your question (twice) as it was reitterated by Vanessa
"Teri asked if you promoted almost an "Atkins" type diet" Guess you haven't had a chance to reply, but I would also like to know.

I don't know much about diets, but I believe that the Atkins represents more protein for weight reduction. Correct me if i'm wrong. "

I can't find it now and I am wondering if I can't say anything about my book because it can be interpreted as marketing. If anyone really cares, I have sold exactly 4 copies of the book (I think I am better at reseach and writing than marketing). I participate on this site as a patient first and foremost. I had terrible GERD for over 20 years. I will try to stick to ideas and content as much as possible. I just thought I had the responsibility to indicate when something was excerpted from my book.

Since I have been asked this question a few times, I am going to give a short answer that is not meant to market this book. My agent does that.

My book's focus in on understanding and treating GERD, not weight loss. My theory is that the consumption of excess dietary carbs is the root cause of the disease because consuming too many carbs leads to something similar to malabsorption which is like lactose intolerance. Microorganisms live in our intestines sharing the food we eat. But they prefer carbs and make a lot of gas in response. This drives reflux for those like us with weakend LESs. The book is science based with numerous references to the scientific literature. My dietary approach, like Atkins, is based on reducing your intake of carbs. My book differs in some key points. My dietary plan calls for limiting carbs for a short time (not two weeks like Atkins) to stop reflux, then gradually adding back carbs using your symptoms as a guide. Cheating is also allowed and expected but carb reduction is an "Ace in the Hole" to stop or prevent reflux episodes. Akins is concerned with weight gain and minimimizing carbohydrate absorption, my book is concerned with eating only as many carbs as we can absorb efficiently leaving few leftovers for microbes get into the action. Protiens and fats are processed differently by microbes and result in much less gas. That is what makes this approach feasible.

Dr. Norm

Teri,
You write "The "Fad" type diets come and go and don't seem to stick around for one's lifetime. To become healthy and remain healthy for a lifetime means following a diet that also promotes a lifetime habit. This type of diet does not".

I respect your concerns and acknoweledge that this debate will go on for years but if you want to understand the other side of the argument, I would suggest you read Protein Power by Dr. Michael and Mary Dan Eades. You might be surprised. If cholesterol, triglyceride levels, blood pressure and obesity improve for most people on (healthy fats, minimize nitrates, etc) reduced carb diets, exactly what is the problem? That is exactly what happened to me. All my numbers improved dramatically and I also feel a heck of a lot better, not to mention putting an end to GERD. Perhaps the USDA food pyramid is wrong and two generations of MDs and dieticians schooled by those MDs are uninformed.

Dr Norm,

You are correct, there are two schools of thought on this issue and until it can be proven that the type of diet that you are suggesting is one that people can stay on for a 'lifetime' and remain healthy all those many years, then I will stick with the "two generations of MDs and dieticians schooled by those MDs".  They've been fairly successful thus far as our elderly population has grown tremendously!

My argument was sort of two-sided though and you missed my main point which was "a lifetime diet".  The diet you are recommending is generally a hard diet to continue with for long periods of time.  Often people go off of it after loosing the weight (which this seems to help with to a degree) and then resume the type of diet that they were eating prior to this.  And therein lies a good part of the problem.  The goal is to have everyone across the country, young and old, eating more heart healthy and eating plenty of fruits and vegetables. 

Re GERD...there are plenty of people that will not be helped completely just by dietary changes alone and must stay on medications, depending on the reason for their GERD or acid reflux.   Little things like teaching people to eat earlier in the evening and lying at an incline to prevent gravity's pull of the acid help greatly!

I'm not completely closed minded on this issue, Dr Norm, I'm reading and learning. :)  I appreciate your point of view as well.

Hugs, Teri

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"Because he is he and I am I."......E. V. Lucas

Teri,
Thanks for your thoughts on this topic. I appreciate your perpective and I wish you the best with your own course of diet and treatment. We all have to listen to our body, our intellect and our common sense.

Dr. Norm

Dr Norm,

Thank you for your info, it helps to have other opinions and share thoughts and ideas.

Hugs, Teri :)

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"Because he is he and I am I."......E. V. Lucas

Hi I am new to this forum . I reading these postings I totally agree with Dr. Norm's opinion of the carb theory and acid reflux. I do know that acid reflux or GERD is aggravated by pastries and breads or high fat or fried and sugary foods. Breads and or flour based foods are highly acidic and high in carbs, so when your upper GI system is over acidic then BAM!!! you get over production of hydrochloric acid from your tiny proton pumps in your stomach! Also it is highly probable that your LES (lower esophageal sphincter) is relaxed and not closing all the way which can allow the gastric acid to reflux back into the esophagus. I would estimate that about 85-90% of people with GERD or acid reflux have Hiatal Hernias which can causes a myriad of symptomatic problems including: tightness in the chest or sternum area, feeling like there is a lump in the throat , burning in the back of the throat, lump in the chest under the sternum, and those are the mild symptoms. The worst symptoms can be vaso-vagal responses that can cause pvc's or pac's (premature ventricular contractions, premature arterial contractions) and other arrhythmias in the heart (which you should be seen immediately by a doctor if you experience these symptoms) that are triggered by irritation to the vagal nerve (10th cranial nerve) that runs from the scull down the side of the esophagus all the way down past the stomach and can be irritated by over acidity from the aforementioned foods. This over stimulation of the vagal nerve is a result of the erosion in the esophagus and or pressure on the nerve from a full stomach and twisting or protrusion of the stomach through the diaphragm due to a hiatal hernia or a problem with LES not closing properly which over a period of time allow the natural hydrochloric acid in your stomach to erode the thin lining in the esophagus exposing the vagal nerve and other various symptoms, the list goes on!.

I experience these feelings like pvc's or pac's in my chest all the time, should I still go to the doctor with each one? It's definately worse after eating, really...it doesn't matter what I eat. Just eating period. I can eat a salad and get the same type feelings as if I ate a cheeseburger. And sometimes can eat a cheeseburger and have no symptoms, it just comes and goes...picks the moment I guess.
Is there anything GERD related that can cause these type feelings, that are NOT heart related? Because I have yet to have any of these picked up on any monitoring equipment, even while "feeling" some of them. Feeling like I was missing a beat or a pvc... none show up.
-Sarah

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I'm 19 year old female. Ever since I had my first panic attack I've been getting crazy heartburn, and its been almost a year. The doc said that the vast amount of stress I am under is aggravating it, and I already have enough to stress about. I rarely get pvc's- prob once a month or so. But when they come, I stress out and go totally nuts. After I've had a meal and I feel that acid coming up, it feels like there is a bubble or something just below my throat. Today after dinner out with my friends I felt that bubble, and then i had a strange chest sensation which i've had before but this time it was more pronounced. It felt like that bubble had sort of popped or moved, but it was right where my heart was in the middle so it sort of felt like it could have been something funny with my heart, but it did not feel like a pvc. So then a little while later I was laughing like crazy and I felt it again, and of course I started to panic so I brought on a whole new set of symptoms that one with panic disorder gets such as dizziness and shakiness. So that lasted about 15 seconds. every time I eat and I have acid I always feel some sort of sensation like bubbling or bubble popping that freaks me out. I've been checked by a doctor cuz I have always mistaken my panic attacks and symptoms for heart problems but she says I just don't got em. I don't know if these sensations are heart related or not, but I get them after I eat and with the acid reflux. I don't know if anyone else has felt anything like this?

yesdear,

Your post on panic attacks caught my eye because I remember seeing something on the web about a doctor who has a specialty in treating panic attacks and GERD - his theory is that in people with panic disorder, GERD is caused by bile reflux. Just do a search on bile reflux panic disorder and you'll probably find the site.

I've had panic attacks before, but it's been about 5 years since I've had them and I've only had digestive problems for about 2 years, so I'm not convinced they're related in my case. But you might find some info that makes sense for you.

-Alliee

Welcome to Healingwell,

LRtrout, Sad to say, but most of these people have moved on, because this is an old thread. Please start a new thread and introduce yourself.

I'm Joy and I'm waiting to be evaluated for a new procedure called EsophyX TIF. Most of the people here have had the Nissen procedure. I chose the EsophyX because it doesn't require cutting (I'm a wimp).

Please stick around. We make great cheerleaders. Also we can answer almost any questions here even though none of us are doctors, just well informed patients.

Joy

Good luck Joy!
Mo

Welcome, Mo!

I didn't get the EsophyX TIF because my Hiatial hernia was too big. Instead I got a partial nissen called the Hill Procedure.

Please start an introduction thread to let everyone met you.

Joy

Sara -

To get back to your question, yes, your diet could be causing your reflux and your "palpitations." Reflux episodes quite often triggered by food allergies, AKA intolerances, and these episodes can trigger heart arrhythmias. It's called cardio-esophageal reflex (not reflux), and it works both ways. The heart can trigger the stomach or the stomach (or esophagus) can trigger the heart. There are research papers online.

I get arrhythmias if I eat the things you noted in your first post: french fries, soda ... and there's a connection between all these foods. They are all loaded with sulfite.

Now you could have a quite different food intolerance connection. MSG is another possibility. To find out all you have to do is keep a food journal and your reactions. Some time ago I posted my list of food intolerances. You should be able to use the search feature to find it.

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Alcie