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What causes heart palpitations with esophageal spasms?

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Posted on Mon, 25 Jul 2016
Question: Two years ago symptom was racing heart followed by upper chest reflux. Happened again two hours ago.
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Answered by Dr. Ilir Sharka (27 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that it is well known that gastro-esophageal reflux can trigger palpitations or exacerbate them.

If palpitations are only related to gastro-esophageal reflux and do not occur in any other circumstances, you have nothing to worry about.

In such case, a proper management of gastro-esophageal reflux (a proper diet and antiacids or PPIs) is enough to control palpitations. No further cardiac tests are needed.

But, if palpitations occur in other circumstances, non in the presence of gastro-esophageal reflux, but also while staying, further tests would be necessary to investigate for possible cardiac arrhythmia:

- a cardiac ultrasound
- an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends during a prolonged time
- thyroid hormone levels for possible thyroid dysfunction
- blood electrolytes for possible imbalance.

Hope to have clarified some of your uncertainties!

Feel free to ask any other questions whenever you need!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka (25 minutes later)
Thanks for your prompt initial response. The patient is my 44 -year old son who is now resting comfortably in another room. Please help me with these four follow-up questions:

1. I understand from you that this situation may be totally related to indigestion and/or better control of gastro esophageal reflux. To the best of my knowledge, his only connection with the racing heart is associated with the reflux.
2. Is there critical value in immediately getting a one-time EGK right now? Or do you feel this is very substandard versus the more comprehensive protocol you outlined in the four-step program of cardiac ultrasound, ambulatory 24-48 hour EKG, thyroid hormone check, blood electrolytes check?
3. Is there an OTC drug that could be taken now (or in a similar recurrence) - prior to a medical exam?
4. Specifically, how about XXXXXXX seltzer chewable (calcium carbonate / antacid simethicone /antigas tablets?

Thanks.

Thanks for your prompt initial response. The patient is my 44 -year old son who is now resting comfortably in another room. Please help me with these four follow-up questions:

1. I understand from you that this situation may be totally related to indigestion and/or better control of gastro esophageal reflux. About a year ago this happened where his heart was racing and he felt a burn in the middle of his chest. After laying down for about 20 minutes, the heart rate went back to normal and the pain went away. This happened again today for the 2nd time in his life and the same 20 minute rest resulted in the pain and racing heart rate going away.
2. Previous to this, he would experience a racing heart beat and shortness of breath a few times a year after heavy cardio exercise. After relaxing for about 3-5 minutes, the heart rate would go back to normal. This has been a regular occurrence for many years but without the burning chest pain.
2. Is there critical value in immediately getting a one-time EGK right now? Or do you feel this is very substandard versus the more comprehensive protocol you outlined in the four-step program of cardiac ultrasound, ambulatory 24-48 hour EKG, thyroid hormone check, blood electrolytes check?
3. Is there an OTC drug that could be taken now (or in a similar recurrence) - prior to a medical exam?
4. Specifically, how about XXXXXXX seltzer chewable (calcium carbonate / antacid simethicone /antigas tablets?

Thanks.

I appreciate what I have been told so far and hope that the four additional questions could be addressed.

Thanks.

doctor
Answered by Dr. Ilir Sharka (7 hours later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

Here are my answers to your question:

1-The situation does not seem to be related to any cardiac disorders. Treatment of gastro-esophageal reflux could help reduce those episodes.

2-It is quite normal to have palpitations during physical activity or anxiety. They are caused by an activation of the sympathetic nervous system and are quite normal in all healthy individuals.

3- As these episodes occur rarely, it is very probable that ECG is normal, because it is performed in a short period of time (some seconds) and it can not catch any of these episodes. An ambulatory 24-48 hours ECG monitoring would examine his heart rhythm trends for a prolonged time and would give much more information. The other tests are indicated when a cardiac arrhythmia is suspected.

4- Regarding OTC drugs he can take antiacids, or raniditine or omeprazole, lansoprazole, etc (which are also called PPI). These drugs can help prevent and treat gastro-esophageal reflux.

5- XXXXXXX seltzer chewable cold also be helpful in this situation to relieve gastro-esophageal reflux.

Hope you will find this answer helpful!

Kind regards,

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

Cardiologist

Practicing since :2001

Answered : 4714 Questions

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What causes heart palpitations with esophageal spasms?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would explain that it is well known that gastro-esophageal reflux can trigger palpitations or exacerbate them. If palpitations are only related to gastro-esophageal reflux and do not occur in any other circumstances, you have nothing to worry about. In such case, a proper management of gastro-esophageal reflux (a proper diet and antiacids or PPIs) is enough to control palpitations. No further cardiac tests are needed. But, if palpitations occur in other circumstances, non in the presence of gastro-esophageal reflux, but also while staying, further tests would be necessary to investigate for possible cardiac arrhythmia: - a cardiac ultrasound - an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends during a prolonged time - thyroid hormone levels for possible thyroid dysfunction - blood electrolytes for possible imbalance. Hope to have clarified some of your uncertainties! Feel free to ask any other questions whenever you need! Kind regards, Dr. Iliri