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Medical opinion required if possible, thank you (Read 2886 times)
lee67
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Medical opinion required if possible, thank you
Dec 15th, 2010, 4:52am
 
Hi all, I have experienced problems with palpitations since taking the anti malarial product Lariam many years ago. My problems occur inconsistently which has caused problems in tracing why I get these episodes and what causes them. After having recorders fitted three times (5 days the maximum time) they have not picked up any major issues just ectopic beats. I have had two independent exercise tests done, heart scans which were all normal as usual! Last night after bending down to feed my cat Archie, my pulse went up to 180 for about one hour, I was resting and hoping it would decrease! Its a pain and very scary, that episode has left me feeling unwell for two days. I also get huge amounts of gas, I'm always burping even if I have had nothing to eat, as soon as I wake I start to burp! I had a recent endoscopy and I have grade 1 esophagitis which my doc just prescribes Gaviscon, I drink this stuff by the bottle but nothing changes I still burp for Queen and country! I was wondering if my burping and bloating could be related to the palpitations at all as the last episode was after pizza and I had quite a lot?

Its started to happen with exercise as well as I ride off road mountain biking about three times a week for 10 miles which I have recently stopped as an episode I had where I was so remote I couldn’t get help. Very frustrating as all the tests are normal and my weight blood pressure etc all good. Would anyone suggest having a recorder for a longer period of time to actually record an event when it happens or as suggested on a trip to my A&E just call an Ambulance when it is happening, they would then do an ECG whilst the event is happening. Previous trips to A&E have resulted in a normal reading as the attack had calmed down due to the test not being done when my heart rate was at 180 whilst sitting down! Best Wishes to you all, God Bless Lee
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RLR
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Re: Medical opinion required if possible, thank you
Reply #1 - Dec 15th, 2010, 5:14pm
 
When you are 10 miles out, what sort of "help" are you anticipating that you might need?

Without doubt, GI disturbances can indeed produce benign palpitation events. The reason is that the GI tract is innervated by the pneumogastric nerve, which happens to merely be an extension of the vagus nerve at that level. Gas or air trapped within the stomach or lumen of the intestines can sometimes result in stimulation of the pneumogastric nerve. The signal travels upward into the vagus nerve proper until it reaches all of the terminal points, one of which is the heart.

The reason that you are undergoing repeated testing with the same negative result is that the palpitation events are not originating from within the heart, nor do they constitute an arrthythmia of pathological origin. To simply undergo testing of this type ad nauseum hoping to somehow obtain a different outcome is highly common among persons who experience them. You conclude that because you are experiencing a symptom, the cause must be a warning sign of a problem with your heart. It's not the case whatsoever and vagus nerve induced palpitations are entirely incapable of ever resulting in a cardiac event. They do not possess the ability whatsoever.

Paroxysmal Atrial Tachycardia, or PAT, is the most common cause for a rapid pulse in the range mentioned and occurs in entirely normal and healthy adults. In the absence of any clinical evidence to support a cause otherwise, it's not an issue of concern.

I would ask at this point about your GI symptoms. Excessive eructation, or belching, can be caused by many things. In athletes, the cause can result from eating energy bars that contain a good amount of a certain type of fiber that results in the offending outcome. In addition, supplements like fish oil capsules can also result in a good deal of indigestion and gas. If you are among those whose diet is chock full of energy bars and beverages, supplements and the like, a change in dietary habits often proves beneficial and a corresponding reduction in benign palpitation events is also observed.

You'll be fine. Be careful not to misinterpret entirely normal physiological occurrences with something pathological. There's nothing wrong with your heart. You can ride 10 miles out, or even 100 and there is no need to have an ambulance follow you around. The events cannot put you at risk of harm or death whatsoever.

Best regards and Good Health



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Best Regards and Good Health
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lee67
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Re: Medical opinion required if possible, thank you
Reply #2 - Dec 16th, 2010, 3:05am
 
Brilliant many thanks for your reply RLR.. Why have all the doctors I have seen not taken the time to explain that to me. So moving forward is a coping strategy to the way my body is and to accept that I have a delicate nervous system. My diet is quite normal no cereal bars or supplements, I eat three meals a day and try not eat too much bread and drink lots of water (no fizzy drinks at all, I do love the taste of water). I have been burping this morning and I have had one cup of tea. If it is normal to experience bouts of 180 bpm and can do me no harm, what should I do when I get episodes of 180 BPM after bending down, I would think to eat smaller meals? I have given up cycling for the moment because it was happening so frequently that I would ride for 10 miles and BAM one big palpitation then I feel awful and struggling to breath, no chest pain just shear exhaustion and feeling very sick to the stomach. I always cycle with an empty stomach so not indigestion related but I do burp whilst exercising. My partner and I used to walk together but I am now paranoid after going on a few walks (5 miles) and Bam the same again what feels like one big palpitation coming (like butterflies in my upper abdomen) and it hits. I am then immobilised and can’t move, completely exhausted again no chest pain just exhausted and have to lie down wherever it happens. Again after an episode I feel like I have been beaten up and very weak which makes walking anywhere a very slow process. I do not think these episodes are psychological as I have always enjoyed exercise and I love the release of endorphins it gives me when I return, I used to say the feeling was as good as sex! It is difficult to give up exercise as I really believe it is vital for good health and I miss not cycling for half an hour every day and doing a small number weight reps for general fitness purposes. Its funny how I get this feeling in the upper abdomen on the day of an attack, the last one lasted all day like that butterfly feeling. I kind of know when it can happen sometimes as I get the feeling like its in the post and going to happen I just don’t know when. I really do appreciate your advice and time taken to respond as I doctors I have seen even Cardiologists have never explained how to cope or why I get these episodes. They just do all the tests and if they come back normal want to get me out as soon as possible, this is very real and effects my life and everything I do. Thank You in advance RLR, Lee
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