DEAR DR. GOTT: I am 25 and developed a funny heart palpitation about eight years ago. It was said by my doctor to be caused by acid reflux. I was given Nexium which solved my constant cough but did nothing to stop my heart flutters. For the first few years they were just annoying but over the last two years, they have gotten to be a problem where it sometimes affects my vision and almost makes me black out. As of the most recent experience, they make my fingers go numb as I get them. I have had several heart monitors and have had a stress test done with all results coming back normal. Please help me if you can.
DEAR READER: Neither occasional heartburn or gastroesophageal reflux disease lead directly to the palpitations you have experienced. In actuality; however, heartburn can lead to chest pain that may mimic palpitations but is due to muscle spasms in and around the esophagus. Acid reflux can appear similar to angina. The difference is the pain from heartburn generally radiates from the upper abdomen into the area of the neck. If a person suffers from both heartburn and angina, the combined symptoms can indeed cause confusion.
Palpitations are very common. Some appear briefly and disappear just as fast. Others can be linked with exercise, anxiety, stress, with standing or bending, occur just prior to falling asleep or, as you have discovered, can be from having acid reflux. There are triggers for any of these occurrences. A person may have consumed too much caffeine, have smoked too much, have a low potassium or sugar level, be dehydrated, anemic, have an over-active thyroid gland, or have a fever. Some medications to include diet pills, OTC cold remedies, particular antibiotics, amphetamines, or the illicit drug cocaine can be to blame for triggering the heart to behave in an erratic manor. Over-the-counter dietary supplements such as hawthorn, valerian, ginseng ,and others can be to blame.
A physician can listen to a person’s heart through a stethoscope for murmurs or other tell tale signs that might indicate there could be something wrong with his or her heart’s valves, causing the palpitations. Generally speaking, an electrocardiogram (ECG) is the simplest means of determining if a problem exists or not. A recording will reveal the heart’s electrical activity that should aid in making a diagnosis. If the testing is inconclusive, a Holter monitor may be ordered which will record all activity of the heart for up to 48 hours while the individual goes about his or her normal daily routine. A diary is kept by the person having the testing to assist with identifying modifications as they occur. For example, if a person is climbing a flight of stairs rather rapidly, the heart may beat faster but the activity will be confirmed by the diary kept. Beyond this and because palpitations don’t occur on a regular basis, an event monitor might be used that can be worn for weeks at a time and is activated by the wearer when symptoms occur to help with the diagnosis.
You may only be having muscles spasms around the esophagus which is why you have had negative cardiac testing. Nonetheless, I would feel better if you took your test results to a cardiologist for a second opinion. If he or she feels all is well and cannot provide answers for your symptoms, perhaps your next visit should be to a gastroenterologist so you can get to the bottom of things.
Readers who would like related information can order my Health Report Hiatal Hernia, Acid Reflux & Indigestion by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
