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Chest flutters. Echocardiography normal. Caused by hiatus hernia or vagus nerve?

Hello Dr. I am a 20 year old male with no history of heart problems (family included,we are all very healthy),and about a year now I am experiencing chest flutters which I am pretty sure are PVC S or PAC S.I have had numerous cardiographs and been tested by a cardiologist with an echocardiogrhy with everything being absolutely fine.I also don t have thyroid problems and exercise tree times a week.Could they be caused by hiatus hernia(haven t been tested) or by vagus nerve?I m pretty scared...
Asked On : Sun, 10 Feb 2013
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

It is not likely from Hiatus Hernia.
Anxiety / Alcohol / Tobacco (smoking, chewing) / Caffeine (too much coffee, cola) are common causes.
Medicines may be responsible – like Phenylephrine used for ‘cold’ / Salbutamol used for asthma and so on.
Illicit ‘drugs’ like Amphetamine are notorious to cause abnormal beats
At times, abnormal nerve paths in the heart (bypass tracts) are responsible!

If the problem is bothering to the extent of interfering with life style, there are advanced techniques of investigations of increasing complexity – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and has a risk (though minimal) and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation.

Take care
Wishing speedy recovery
God bless
Answered: Mon, 11 Feb 2013
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