Acid reflux and bounding pulse, left side of upper abdomen bulges out
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I am a 28 yeard old male and for many years I have had symptoms of a bounding pulse, a very strong pulse that is there 24/7 as well as acid reflux. I am on PPIs which massively help. For cardiac symptoms I have had every test that shows my heart is towards the upper limit of size with a low HR (40-50) and high stroke volume. My blood pressure is good at 100/60. There is nothing on paper massively wrong, but I can't find a solution to my excessively strong pulse. The cardiac investigation is still on going. I have tried beta blockers which actually makes my symptoms worse, which I believe is due to slowing my heart rate down more and making my stroke volume larger. I have quite exercise in order to try and bring my heart rate up.
Most supplements seem to trigger my palpitations, especially vitamin d. I suspect they make other peoples heart beat harder too, but they perhaps don't notice it. My symptoms are ruining my life somewhat. I sleep for 8 hours a night but feel exhausted as I do not feel like I get deep sleep. This is because the pulse does not let my brain rest fully as it is happening 24/7. I know default in this situation is to suggest anxiety as there is no obvious cause, but I don't believe this is the case as beta blockers make it worse and I also tried anxiety medication which either has no effect or makes it worse.
The upper left centre of my abdomen sticks out, near where I feel my heart beating. I don't know if perhaps there is some kind of hernia or other kind of lump? I've attached photos.
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