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What Causes Fluctuating Heart Rate And Stomach Issues With A History Of Tachycardia?

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Posted on Thu, 9 Jun 2016
Question: hello
im still having some issues with my stomach. i will try to keep history short. basically 49y wm with sleep apnea. afib cardioverted 2013. multiple occurances of sinus tach but nsr. all cadio,echo and XXXXXXX tests revealed no blockage or structual issues or valve issues. XXXXXXX Clinic specialist indicated i most likely had hiatal hernia and gerd causing the sinus tach. medicine changed from metatropol TO nadalol and put me on nexium 40mg daily. Everything great for a year. last week had lump in throat and pressure of gas (same situation i had a year ago). I did eat barbaque chips and meal and took nap right after eating which i dont do. my heart rate usually 59 but when i had lump in throat my pulse was going as low as 43? i also noticed my bowel movement was more like spaghetti and small amount. i took some pepcid and some apple vinegar to resolve gas. i could actually feel lump feeling become less from apple vinegar. last few days lump feeling almost gone, bowel movement more regular (log type). My pulse is also back around 56 to 65.

a few questions, why the heart rate chage? why the change in bowel movement? it almost seemed like bowel movement process stopped. Suggestions to what it is? Roemheld syndrome?
doctor
Answered by Dr. Ilir Sharka (3 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

I carefully passed through your medical history and would explain that you are right on your suspicions.

Whichever be the term: Roemheld syndrome, or gastric triggered cardiac symptoms, it seems that a gas-related digestive distension has led to vagus nerve stimulation with the subsequent heart rate response.

So, transient bradycardia seems to be a response to the autonomic nervous system modulation.

Your recent symptomatology (lump in the throat, increased bowel movement) supports such an alternative.

Whether the initial triggering factor leading to gas overproduction is;

- food intolerance,
- hiatal hernia,
- acid reflux (GERD),
- IBS (irritable bowel syndrome), etc.

This needs to be further investigated.

My advise would be to carefully select your meals profile, avoiding spicy and fatty foods.

Also some medications like antiacids (pantoprazole, omeprazole, etc.) and antigas drugs (simethicone, etc.) would be helpful.

Hope to have been helpful to you.

In case of any further uncertainties, feel free to ask me again.

Kind regards,

Dr. Iliri




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (11 minutes later)
thank you, i have a colonoscopy and scope of stomach scheduled for may 17. i have alot of gas even with nexium and apple cider vinegar during this bout. this entire time i felt vagus nerve is an issue somehow. prior to switch to nadalol i would almost feel dripping in stomach and within a minute my heart would race in nsr. once on nadalol it appears this blocks this rush and has been great. i think 90% of issues is stomach related. whats strange i never had burning in throat. overall feeling great with heart just a flare up. one the past year isnt bad. hopefully lump goes completely away since it is 5 days. thank you
doctor
Answered by Dr. Ilir Sharka (13 hours later)
Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again,

I agree with you that a nervous vegetative component should be adversely implicated in your recent symptomatology.

The programmed endoscopic procedures will certainly clarify whether digestive structural or functional issues are present (such as hiatal hernia, gastro-esophageal reflux, irritable bowel syndrome, etc.) justifying such way the reason of vagus nerve heightening.

Regarding the burning sensation and lump in throat it seems to be related with two components:

- GERD (gastro-esophageal reflux),
- Anxiety

Both of them seem to exacerbate each other.

Nevertheless, I believe everything will be clarified soon.

Please, let me know how the medical tests will conclude!

In case of any available test reports, I would be happy to directly review them and give a second professional opinion.

Could you upload them here?

Regards,

Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9536 Questions

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What Causes Fluctuating Heart Rate And Stomach Issues With A History Of Tachycardia?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome on HCM! I carefully passed through your medical history and would explain that you are right on your suspicions. Whichever be the term: Roemheld syndrome, or gastric triggered cardiac symptoms, it seems that a gas-related digestive distension has led to vagus nerve stimulation with the subsequent heart rate response. So, transient bradycardia seems to be a response to the autonomic nervous system modulation. Your recent symptomatology (lump in the throat, increased bowel movement) supports such an alternative. Whether the initial triggering factor leading to gas overproduction is; - food intolerance, - hiatal hernia, - acid reflux (GERD), - IBS (irritable bowel syndrome), etc. This needs to be further investigated. My advise would be to carefully select your meals profile, avoiding spicy and fatty foods. Also some medications like antiacids (pantoprazole, omeprazole, etc.) and antigas drugs (simethicone, etc.) would be helpful. Hope to have been helpful to you. In case of any further uncertainties, feel free to ask me again. Kind regards, Dr. Iliri