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What Causes Persistent Heart Palpitations And Acid Reflux?
Question: hi, im 28 yrs old 6ft tall and about 300LBS. For the last 2 years I have suffered day and night due to persistent acid reflux that affects increases my heart rate. It seems likei have not had a single normal heart beat since my ordeal began. the trouble started after I was diagnosed with hpylori which I took medicine for. I did an endoscopy later after the fast heart rate and severe reflux persisted and it showed pretty bad inflammation (moderate to severe) in my upper oesophagus. its so bad that I belch acid. sometimes I wake up with a mouth full of acid. I don't sleep lying down nor do I eat late at night but my heart still pounds all night long and all day long. i cannot even walk after iv had a bite to eat because any food in my stomach seems to spike my heart rate so much that i have to sit down after a few steps. even when i haven't eaten anything my heart rate still spikes up when i walk for even a few minutes. the veins on the the side of my neck tense up and i can feel and hear my heart just pounding out of my chest. Iv had ekgs ct scans mri's done and everyone says im fine and to get the acid under control but it isn't improving. its getting worse. a few months ago i experienced ventricular tachycardia when i was running in the gym. after 2 days observation the doctors released me saying i was fine. My heart pounds so hard and so fast that it wakes me up at night. it literally shakes my body when its at its worst. Im always belching acid. im so desperate at this intrusion in my life that for the first time i even thought of ending my life. its just unbearable. iv started loosing weight to get healthy but also because i cant eat much due to this problem. I had two boiled eggs for dinner last night and i could barely sleep due to the acid. when im walking i feel the acid coming up my oesophagus burning my chest and spiking my heart. im desperate for some help. anything. Im a student and its really hard to concentrate when all you can hear is blood in your ears. I got put on metropolol for the heart rate but it doesn't seem to help. Iv been on nexium, Carafate, zantac, sucralfate, pepsid etc nothing is helping me. I just don't know where else to turn. Iv already been to the ER 3 times this year due to my heart issues resulting from this. my bp was pretty normal but for some reason this pounding makes it spike up, gives me headaches etc. i cant exercise which i used to do a lot because any exertion is just brutal to my heart rate and the acid burns so much.
Brief Answer:
explained
Detailed Answer:
Hello and Welcome
I have read your history carefully.
I very much appreciate your concern.
Let me address a few issues that may help you focus on the solutions.
Based on your BMI , which I calculated via weight in kg divided by Height in meters squared, which came out to be around 41.05 which is very high.
Lorcaserine is indicated in a BMI of > 30 Kg/meter squared if there is also a weight related co morbid condition like hypertension, dyslipidemia, Diabetes. so if you fit the criteria, You may discuss this option with your doctor to help you loose weight effectively.
The GERD issue especially with the recurrence despite the Hpylori treatment, needs to be addressed in more than one ways. Firstly, a high dose empiric therapy is standard of care in most guidelines before invasive investigations are done. A useful and common regimen which I use in my clinic is Esomeprazole 40 mg bd, itopride 50 mg tds, sucralfate tds, Bismuth subsalicylate tds.
If despite a two week treatment the symptoms persist and endoscopy is clear, then you may go for 24 hour PH monitoring to confirm GERD.
Diet changes are necessary.
Diet changes are quite simple that you need to make. Do not complicate them by following complex regimens. Take 5 small meals a day consisting mainly of low carbohydrates , high fiber and low fat ingredients. Participate in 30 minutes of exercise twice daily. Avoid cola, caffeine, ice cream and over processed food as much as you can. Avoid eating after 9 PM at night. Keep a diet diary to record your daily routine for it to make a habit to see how you respond and what progress you make along the way.
The palpitations , esp that the EKG etc are clear indicate panic attacks. Propranolol is better than metoprolol in this regard. you may observe your sleep patterns to see if you have insomnia and may take lorazepam 1mg at night for two weeks to regularize your sleep and overall calm yourself down.
I would suggest you consult a psychiatrist
so that a XXXXXXX mental state exam is performed.
to ascertain depression and or anxiety,
Meds can be adjusted afterwards in addition
to cognitive behavioral therapy. Yoga and meditation ,
too have proven benefit n addition to relaxing exercise.
Let me know if you have any query
wishing you best of health
Thanks
explained
Detailed Answer:
Hello and Welcome
I have read your history carefully.
I very much appreciate your concern.
Let me address a few issues that may help you focus on the solutions.
Based on your BMI , which I calculated via weight in kg divided by Height in meters squared, which came out to be around 41.05 which is very high.
Lorcaserine is indicated in a BMI of > 30 Kg/meter squared if there is also a weight related co morbid condition like hypertension, dyslipidemia, Diabetes. so if you fit the criteria, You may discuss this option with your doctor to help you loose weight effectively.
The GERD issue especially with the recurrence despite the Hpylori treatment, needs to be addressed in more than one ways. Firstly, a high dose empiric therapy is standard of care in most guidelines before invasive investigations are done. A useful and common regimen which I use in my clinic is Esomeprazole 40 mg bd, itopride 50 mg tds, sucralfate tds, Bismuth subsalicylate tds.
If despite a two week treatment the symptoms persist and endoscopy is clear, then you may go for 24 hour PH monitoring to confirm GERD.
Diet changes are necessary.
Diet changes are quite simple that you need to make. Do not complicate them by following complex regimens. Take 5 small meals a day consisting mainly of low carbohydrates , high fiber and low fat ingredients. Participate in 30 minutes of exercise twice daily. Avoid cola, caffeine, ice cream and over processed food as much as you can. Avoid eating after 9 PM at night. Keep a diet diary to record your daily routine for it to make a habit to see how you respond and what progress you make along the way.
The palpitations , esp that the EKG etc are clear indicate panic attacks. Propranolol is better than metoprolol in this regard. you may observe your sleep patterns to see if you have insomnia and may take lorazepam 1mg at night for two weeks to regularize your sleep and overall calm yourself down.
I would suggest you consult a psychiatrist
so that a XXXXXXX mental state exam is performed.
to ascertain depression and or anxiety,
Meds can be adjusted afterwards in addition
to cognitive behavioral therapy. Yoga and meditation ,
too have proven benefit n addition to relaxing exercise.
Let me know if you have any query
wishing you best of health
Thanks
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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