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I'm having problems. (Read 2927 times)
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Heart Palpitations
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I'm having problems.
Feb 07th, 2013, 1:28am
 
Anyway, here goes.  42 y/o male--seen in the ER twice recently.  Once for constipation like sx and then again two weeks later w/ HR above 110/PVCs and palpitations, sweating, neck pain (right sided) and slight trouble swallowing with feeling of being strangled.  All cardiac labs negative.  After first visit to ER, I took their fiber diet/prescription seriously.  Then the the tach/palp and sob (feel like running and I'm not) two weeks later.

Three days ago, I took an gas-x and it reduced the palpitations.  On the other hand, I don't know if it was the act of putting something in stomach reduced symptoms.  Either way, I began considering two things--hietal hernina or gallbladder symptoms.  Ordered for now is a stress test, GI consult, endoscopy, stress test and h-monitor.  I've had palpitations in the past but not accompanied by tachycardia, at least not to this severity and time.  

PPIs for start and reduction of cymbalta.  I do take narcotic pain relievers for back pain.  (retired vet and disabled).  I have pain in between my shoulder-blades and right sided neck pain often as of late.  It feels different than previous pain in back (reason for pain relievers).  Also have occasional pn behind right eye.  No idea why.

I'm not in great pain regarding palps.  My heart rate does reduce to 70s -100 but I can't be as active as I was just a week ago without feeling the palps.  I do feel heavy in the chest, even sore sometimes.  I'm pre-diabetic and hx of HTN.  I take lisinopril and water related meds.  

Eating does at points relieve the symptoms or cause the palpitations, neck hold and/or pain and slightly lightheaded occurs spontaneously.  

Truthfully, I'm scared and agitated beyond memory.  I really don't feel like Ill  live through this.  Forgive punctuation and grammar...I'm so tired.    
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RLR
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Re: I'm having problems.
Reply #1 - Feb 10th, 2013, 5:48am
 
Okay, welcome to the forum and I've read your postings and concerns.

Firstly, you're in no actual danger and the type of rhythm disturbance or palpitation you are referencing holds no capacity whatsoever to place you at risk of any type of cardiac event or jeopardy otherwise. The belief is often established that disturbances of this type are a potential segue to a dangerous arrhythmia and it's simply not the case. These palpitations actually originate from outside the heart and the heart muscle is merely responding to their influence, not as a result of challenge by the heart as an organ. In other words, the symptom doesn't constitute a warning sign that anything is wrong. As stated in many instances, the events are more akin to a muscle twitch than any type of arrhythmia. Remember that the heart is as much a muscle as it is an organ and is susceptible to the same influences.

GI difficulties can very readily produce palpitation events because the nerve which innervates the GI tract is the very same nerve pathway to the heart. The vagus nerve, termed the pneumogastric nerve at the level of the GI tract, is the largest mixed nerve in the body and serves function to many organs and regions other than the GI tract and heart.

Whenever an individual comes under significant stress and anxiety, it alters the basal performance of the central nervous system, in particular inducing a heightened status. Under such influence, mild altered nerve function occurs to include sensory disturbances and wayward nerve impulses. In the instance of the vagus nerve, these impulses travel along the nerve's pathway until they reach the terminal endings, causing the attached organ or tissue region to respond in an equally unnatural context. Incidentally, this is also worth mention with particular respect to the eye pain you are experiencing, which should not be confused with the type of orbital pain and papilledema associated with certain demyelinating diseases such as Multiple Sclerosis. Pain between the scapulae or shoulder blades is also a very common complaint by persons experiencing significant stress and is musculoskeletal in origin. The same is true of the torticollis-like neck pain.  

The belief that something serious is wrong can often arise due to the cyclic nature of the problem that becomes reinforced as matters seem to grow worse, with no ability by the medical community to define a cause which is consistent with beliefs established by the patient. As fear of a serious consequence intensifies, so does the influence of anxiety and this only imparts greater symptomatic features.

A reduction in GI symptoms will directly correspond with relief of the palpitations with respect to frequency and intensity. Although frightening, the palpitations will never cause anything to occur other than the symptomatic sensation itself. There has never been even a single case of serious morbidity or mortality associated with the presence of the type of palpitation events you are experiencing, so you can take a deep breath and relax from that standpoint. The more pressing matter is the actual underlying reason for the somatic anxiety.

You're going to be fine. The pending tests will not reveal the presence of anything serious and working closely with your doctor in treating your GI symptoms successfully will go a long way to help reduce other symptoms presently of concern to you.

Best regards,

Rutheford Rane, MD (ret.)



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Best Regards and Good Health
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