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What causes pain and palpitations in the abdomen below the sternum?

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Posted on Tue, 4 Sep 2018
Question: My husband is complaining of a 'fluttering' just above his stomach and just below his sternum. He seems to have a strong pulse but slightly elevated blood pressure 130/80. His norm is about 112/ 72. He says it doesn't hurt but he'as worried it may be a femoral artery. I don't want to make an unnecessary trip to emergency but will if needed. Any thoughts?
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Answered by Dr. Ramesh Kumar (1 hour later)
Brief Answer:
He is having palpitations.

Detailed Answer:
Hello,


The feeling he is having is called palpitation. Palpitations can feel like the heart is fluttering, throbbing, flip-flopping, murmuring, or pounding. However, in some cases these sensations can be felt in abdomen stomach, limbs and head also as in the case of your husband.

1)Strong emotional responses, such as stress or anxiety-Extra-cardiac stimulation of the sympathetic nervous system (inappropriate stimulation of the parasympathetic nervous system, particularly the vagus nerve (which innervates the heart), can be caused by anxiety and stress due to acute or chronic elevations in glucocorticoids and catecholamines hormones which can cause palpitations.

2)Over use of nicotine and caffeine.
Common abnormal heart rhythms are-
ectopic beat, premature atrial contraction, junctional escape beat, premature ventricular contraction, atrial fibrillation, supraventricular tachycardia.

3)Overactive thyroid. Palpitation may be associated with electrolyte imbalances of magnesium, potassium and other salts in serum.

4)Gastrointestinal distress such as bloating or indigestion, along with muscular imbalances and poor posture, can also irritate the vagus nerve causing palpitations)

Suggestion-

I would prescribe you following tests:
1) Thyroid profile- to rule out hyperthyroidism.
2)24 hour Holter monitoring- will record the ECG continuously during a 24-hour or 48-hour period. If palpitation occurs during this period it will be recorded in ECG recording and we can rule out the cardiac rhythm at the time.
3) Serum electrolytes - a disturbance in serum electrolytes can cause palpitations , they can be corrected easily.
4)If he is a smoker give up smoking.
5)Don't take alcohol in excess.
6)Try to do 45 minutes of exercise daily.
7)If he is anxious person with elevated anxiety levels cardiologist will prescribe him with benzodiazepene to lower anxiety.
8)Don't eat oily ,fatty and spicy food for some days.
Add fibres to your diet.

The above mentioned investigations are the basic test which can be helpful in finding out the cause of palpitations.
As prevention is always better than cure, I would suggest you to take the problem seriously.

Take Care!

Regards,
Dr. Ramesh Kumar,
Gastroenterologist

Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

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What causes pain and palpitations in the abdomen below the sternum?

Brief Answer: He is having palpitations. Detailed Answer: Hello, The feeling he is having is called palpitation. Palpitations can feel like the heart is fluttering, throbbing, flip-flopping, murmuring, or pounding. However, in some cases these sensations can be felt in abdomen stomach, limbs and head also as in the case of your husband. 1)Strong emotional responses, such as stress or anxiety-Extra-cardiac stimulation of the sympathetic nervous system (inappropriate stimulation of the parasympathetic nervous system, particularly the vagus nerve (which innervates the heart), can be caused by anxiety and stress due to acute or chronic elevations in glucocorticoids and catecholamines hormones which can cause palpitations. 2)Over use of nicotine and caffeine. Common abnormal heart rhythms are- ectopic beat, premature atrial contraction, junctional escape beat, premature ventricular contraction, atrial fibrillation, supraventricular tachycardia. 3)Overactive thyroid. Palpitation may be associated with electrolyte imbalances of magnesium, potassium and other salts in serum. 4)Gastrointestinal distress such as bloating or indigestion, along with muscular imbalances and poor posture, can also irritate the vagus nerve causing palpitations) Suggestion- I would prescribe you following tests: 1) Thyroid profile- to rule out hyperthyroidism. 2)24 hour Holter monitoring- will record the ECG continuously during a 24-hour or 48-hour period. If palpitation occurs during this period it will be recorded in ECG recording and we can rule out the cardiac rhythm at the time. 3) Serum electrolytes - a disturbance in serum electrolytes can cause palpitations , they can be corrected easily. 4)If he is a smoker give up smoking. 5)Don't take alcohol in excess. 6)Try to do 45 minutes of exercise daily. 7)If he is anxious person with elevated anxiety levels cardiologist will prescribe him with benzodiazepene to lower anxiety. 8)Don't eat oily ,fatty and spicy food for some days. Add fibres to your diet. The above mentioned investigations are the basic test which can be helpful in finding out the cause of palpitations. As prevention is always better than cure, I would suggest you to take the problem seriously. Take Care! Regards, Dr. Ramesh Kumar, Gastroenterologist