Strange combination of GERD/cardiac symptoms

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Hi everyone. I'm a 27 y/o male. For about the past year, I've had acid reflux that has progressively gotten worse to the point where I'll have extreme heartburn, indigestion, and regurge. It's so bad I can't fall asleep. I've taken every OTC heartburn medication but nothing lasts long enough or is strong enough to stop my symptoms. I started taking prilosec OTC almost a year ago and that has worked the best for me but sometimes I still have to supplement with antacids for immediate relief. About 6 months ago, my resting heart rate started to increase to around 100 BPM, I would get out of breath quickly just going up the stairs, and I was getting chest pains and occasional palpitations. I was also getting a tightness feeling in my throat, a crushing pressure feeling on my chest, and I was feeling like I might die.

My family doctor did an EKG and sent me for an echo, both of which came back completely normal. He diagnosed me with anxiety and he referred me to a GI doctor to get the reflux symptoms checked out. He also prescribed me propranolol (a beta blocker) to treat the cardiac symptoms and prescription prilosec. The GI doctor wants me to have an upper endoscopy done (I'm having it done this Monday) especially since my grandfather has Barrett's esophagus.

I still get indigestion and regurge almost daily but no heartburn. I've been avoiding trigger foods and eating smaller meals. I've also elevated the head of my bed so I can sleep easier. My chest pains are now occuring almost daily and I often have the tightness feeling in my throat. The chest pains are usually dull but can occasionally be sharp and only last a few seconds to a couple minutes and they come and go throughout the day. However, they occur more at night. I'm suspecting it's Non-Cardiac Chest Pain (NCCP) caused by GERD. It's very hard to ignore chest pain when it happens because I constantly think what if this is a heart attack? But I don't get any other heart attack symptoms at the same time and they usually go away.

I'm also experiencing a strange pressure feeling in my chest and in my throat when I lie down on my left side or if I put pressure on my upper back when lying down. I typically sleep on my right side now. I also get extremely annoying palpitations almost every night when I go to sleep. I can feel my heart pounding when I'm lying down so now I usually prop myself up on 3 or 4 pillows so I'm almost sitting up and that usually alleviates the feeling. Also, as I start to fall asleep, I'll feel a horrible jolting, rushing feeling in my stomach and it wakes me up immediately and I take a big gasp of air. It usually happens once or twice a night but sometimes it'll happen several times as I'm trying to fall asleep. It's a very scary feeling and it can set off a panic attack, which keeps me up. Some nights I just stay up for hours with chest pains and palpitations and every time I try to fall asleep, I get that weird jolting feeling. I'll eventually become so exhausted I fall asleep. Sometimes I'll wake up in the morning and feel like I'm going to faint so I'll sit in bed until it passes.

I'm hoping the upper endoscopy doesn't reveal anything abnormal. I'm seeing my family doctor next week for an update (I see him every 3 months) and I'm going to tell him how much worse my symptoms have gotten. I feel like I'm going to die at any moment because of these strange cardiac symptoms. When all of these symptoms start happening, I'll have a sense of impending doom (classic anxiety symptom) and I'll have to distract myself and calm myself down. I'm not sure if the GERD causes the anxiety/cardiac symptoms or if it's a combination of GERD and anxiety. I just need some relief. 

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  • Posted

    All the things you have done for your sleep are common and generally helpful.

    Side of sleeping is a well known issue.

    Heart Attack - I sympathise! However it's necessary just to consider the non chest related symptoms, and forget the link between chest pain and cardiac issues. (I currently have a fractured rib and bruised sternum, breathing is painful, and excercise makes it cronic.. I think of a heart attack multiple times a day)

    I see more and more mentions of links to anxiety (my wife has this also) - hard to know if it is a co-symptom or a side effect of the meds, or an effect of endless health issues (or statistically no more likely... just part of life). Even if the issue is studied and a proven increased likelihood, it's still going to be there so whatever you can find to help (lifestyle/meds/counselling/etc) is worthwhile.

    Sleep shock / jolting / waking with a panic is a very common sleep disorder - sometimes it's neuro (poorly understood - some think a missfire in the cerebellum as the upper brain functions are shutting down) and sometimes it's actually sleep apnoea. 

    My only useful bit of advice is to push for regular Endoscopy! Long term reflux gives increased risk of other conditions in the throat. If the GP understands this and thinks about the many treatments that can be avoided, then even better chance of being referred for a Fundoplication 

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  • Posted

    Hi Pancham,

    I do sympathise. Acid and reflux can cause many distressing symptoms.

    I'm glad your omeprazole is now on prescription. It should mean your doctor will monitor its use. The fact you found it beneficial for your heartburn and indigestion is an indication you were actually refluxing acid. If you don't feel those pains now, it's probably because they are working but could also be attributable to development of Barrett's which is less sensitive than the normal squamous mucosa. Your scope on Monday will ascertain that. Hopefully not but if you have Barertt's, you do need to know.

    The vagus nerve runs beside the esophagus. Refluxers often experience problems with rogue signals sent via this nerve which can trigger some tachycardia along with symptoms mimicking heart attack. Of course, these symptoms must be taken seriously. My father, who suffered acid reflux all his life, died of a heart attack when I was a young teen over 50 years ago, probably thinking it was indigestion again.

    I have had reflux issues all my life (and know I've had Barrett's at least 23 years) . I have had so many ECGs, echo grams, etc over the years and even have an implanted LINQ heart recorder device. But every single test on my heart has shown it is perfectly healthy. Having said that, if I eat too fast or eat too much, I can experience rapid heart beat accompanied by profuse sweating and mild deliria.

    Your Prilose (omeprazole) is conrolling your acid, you need to control the reflux too and (easier said than done) try to reduce the anxiety.

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  • Posted

    Hi. Your symptoms sound horribly frightening. But like you it's so difficult to tell whether it's gerd or yr having a heart attack. Every time I've seen a consultant they have said it's classic reflux. Medications are supposed to control the acids but other stuff will still come up yr oesophagus. The best thing to have yr endoscopy and then that will confirm any hernia/Barrett's at least you'll know one way or the other. There are lots of options open to people who really are suffering from Gerd. I'm sure a consultant will tell u yr options. Stress and anxiety really do make the condition worse but it's so hard to just relax and forget them as the discomfort is always there. Let me know how you get on. You just need answers to why your feeling so rubbish

    Take care

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  • Posted

    Thanks for your replies everyone. The endoscopy revealed a hiatal hernia. The upper portion of my stomach is coming through my diaphragm and stomach acid is getting trapped there, causing acid reflux. It's also putting pressure on other organs, causing the chest pain and shortness of breath. My GI is going to do a upper GI x-ray to see how far the acid refluxes and to too how large the hernia is and this will determine if I need surgery to correct it. It's such a relief knowing this is the cause of most or all of my symptoms smile and it's not as sinister as I thought it might be (esphageal cancer, barrett's esophagus, mediastinal mass, aortic aneurysm, etc. My mind worries). My GI said surgery will likely stop all of my symptoms as well. 

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