I have a very large hiatal hernia that does not cause any problems such as Gerd, reflux, etc. but I did experience a loss of four units of blood over a period of nine months in 2007and after a blood transfusion did not lose blood again until recently when hemo went from 14.5 down to 9.9 in three months. A colonoscopy and endoscopy in 2007 did not reveal any reason for the blood loss. My gastroenterologist did mention that my hernia might be the source of my bleeding but neither he nor my primary physician suggested any further treatment. My main concern are other symptoms that I continue to experience in addition to the bleeding. I have shortness of breath, and have severe chest pain that extends up into my neck whenever I exert myself , but get immediate relief upon resting for ten minutes. I have had two heart caths in four years and numerous electrocardiograms and echo stress tests and have had my heart valves checked and the doctors say there is nothing wrong with my heart. My question is whether or not all of these heart symptoms could actually be caused by the extremely large hiatal hernia? I also experience a very rapid pulse rate upon very little exertion. Just cleaning off kitchen island or eating can sometimes raise pulse rate to 109. Could this also be caused by hernia? Thanks for any comments.