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The Hiatal/PVC/PAC Connection

Why aren't more doctors aware that hiatal hernias can be the cause of irregular heartbeats with patients who otherwise have healthy hearts?  Although we are told PVC's/PAC's are not life threatening, I can tell you that for many of us it is a debilitating condition.

There is a large market out here patiently waiting for a cure.  Why isn't there a medication to treat this illness?

Marya Taylor  
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612551 tn?1450022175
COMMUNITY LEADER
I don't know where you got your information, but I'm not contesting it.  I respond more because I see your post slipping to the bottom of page 1, and don't like to see a post go without any attempt made to help.

Given the accuracy of your statement, the question appears to me rhetorical, which puts of many who may have some related information.  I do not think may MDs read this, and other than them and/or the medical educational systems of the world not doing their job being the reason it would take such a representative provide an answer.

You are, I read, suffering from PVC/PAC, is it due to a hernia?  Are the "standard" medications being tried to provide you at least some relief?
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363281 tn?1590104173
I have a hiatal hernia, and I know for a fact that sometimes it is the cause of my PAC's. If I eat a large meal or drink lots of water then bend down or slouch, even walk, they will certainly act up. I believe it is due to the hernia protruding through the diaphragm and then touching a cardiac reflex or vagus nerve, this in turn causes those dang things to act up. It is horrible, and I wish more doctors would recognize this instead of saying nothing or acting like you are a little nuts. It is a real problem, I know from experience.
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Avatar universal
I was diagnosed some years ago with a small hiatal hernia.  Since the age of about 24 I have had PVC/PAC's, but they were just small flutters that occurred very occassionally.  About two years ago, the extra beats became more chronic and difficult at times to catch my breath and function.  Although doctors tell you it is "not life threatening," it certainly compromises the quality of your life.    Most of us concur when you get more than 20 episodes in one hour of double or triple beats, it limits your lifestyle and will eventually compromise your life.  If you are having a really bad spell of "IT" you simply cannot function.  I want to tell you now, I plan on living an active life style well into my 80's and feel that if I do not "nip it" while I can still "fight it" I will become eventually incapacited by  "it."  Who wants to sit on their bum and wait to die?????    

The cardiologist said there was not a connection betweem this and my hiatal hernia..  I pressed him further and used the terms vagal nerve, he still said no connection.  The only medication I am on is to treat a slightly elevated BP.  I am 5'6, weigh 138#, and very active and otherwise healthy.  In fact, walking, step aerobics, etc. seems to aleviate the beats. ( I read a post on Dr. Kim's web site, that jumping down can help a sliding hernia pop back into the stomach cavity.  So maybe this is why activity of this nature works?  Also, Dr. Kim recommends slightly pressing in a downward motion starting at the bottom of the sternum toward the belly button.)

My internal medicine doctor listened to all my symptoms and suggested the possiblity that it could be related and I try Prylosec for the stomach pain/bloating, etc.  It actually does help by quieting my stomach.  What most of us have found (through the process of deduction), a quieter tummy means less PVC's/PAC's. However, this does not sufficiently limit the number of attacks. ( Wouldn't it be great if there were a medication that was timed released to reduce the acid and quieted the vagal nerve response? )

So, getting back to your question, am I being sufficiently treated for the PAC/PVC's....no.  The problem is, there cannot be a treatment if someone out there does not recognize that there is a relationship (complex) between hiatal and PVC's/PAC's.  In order to treat a disorder a difinitive diagnosis must be made.  

I have been following this thread for years, however, just signed up this past week, because I want to find a way to bring this to the attention of the medical community and drug research companies.

From what I have read on this thread and within the scope of the community of  people I know as fellow sufferers,we all seem to feel that what is going on in the stomach is affecting the heart.  

Are you in a position to represent us, or can you advise me of someone who can? In fact, can anyone reading these threads suggest a way to collaborate effectively to get our condition diagnosed and treated.   I think that this new drug has the potential to become a highly lucrative one.
  
Although it is great to have a group of fellow suffers who are in concurrence and agree that something more is going on we are not solving for the problem.  I have always felt that if you are going to complain about something also be willing to come up with a solution.

When you know better, you do better.  We all know there is a connection, it is time to DO something about it.  

Marya Taylor
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1 Comments
i know this post is waay old, and I just happened upon it now. I'm a Registered Nurse in the U.S. And I suffer from bouts of palpitation. They happened for the first time about 3-4 years ago out of no where after I had some oatmeal in my car driving to work. A doctor told me to drink more water and that they may go away. Well after a couple of hours they did go away. Then another isolated time while i was laying in bed watching TV. Then they disappeared for a year or more. Then I started at a new hospital and a far more stressful position, and I had them daily. Went and saw a cardiologist and EKG, Echo was fine. He said they were stress related. Well I started to notice that I would get them around the same time daily and they would go away around the same time daily. I started dieting and exercising and then they went away for a few months. Recently, they have come back and they are lighter than those i was getting daily previously, but they can last all day. They usually start some time in the morning sometimes after I've eaten my daily oatmeal or sometimes start soon after I wake out of sleep. As previously, I had thought that they may be linked with diet, small hy hernia, etc. I asked a Doc I work with why they all write off hy hernia or vagal stimulation as the cause of palps and he said simply, "we aren't taught that in medschool, no one has really proven it yet." and that's what it comes down to. For docs if it's not extensively researched and proven, they write it off as imaginings of desperate, anxious, people looking for answers to an issue that is harmless. They think, "bah, stop yer whining, your not sick, just deal with it." but we know that sometimes these palps can be all consuming. I had them this moring, but I laid down and they went away thank heavens. But, i say try natural remedies before the Rx. BBs and Ace inhibitors are not the solution most of the time and will just leave you with side effects for as long as you take them. Thank you for those whom share their experiences, and their solutions, it does make others feel not so alone and scared. It also give hope to those who feel hopeless.
Avatar universal
I mention in my post to Jerry that my first attack was around the age of 24.  I happened to bend down to pick up a tennis ball and my heart went into a wacky mode....two beats, stop, three to four fast beats, stop...for several minutes.  It was about 1/2 hour after a meal.  That first occurence was sure scary.  I went to the Dr. and he found my heart to be perfectly healthy.  Does that sound familiar to you??  About two years later, I was experiencing some stomach problems, and had a gastroscopy.  The only thing found was a small hiatal hernia.

In between 24 and age 53, I would have an occasional thump or two.  At 53 I experienced a bad prolonged attack and sought medical advice for relief.  As most of us concur, insufficient treatment for this disease.  For the last two years, I have been what most of us would term "plagued" by irregular heart beats.  I really wouldn't have known I had a hiatal hernia except for the diagnosis and the fact that I do suffer with burping, occasional heartburn...who doesn't and a really fast digestive track.  In today, out tomorrow!!  Hah, hah.

I hope you and other suffers will form a coalition to find a cure.  It is not the worse thing in the world, however, it does impact your lifestyle and happiness.

Sincerely,
Marya Taylor    
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Avatar universal
I have had ALL the tests known to the medical profession with regard to GERD and hiatal hernias.  There is no indication of any abnormal reflux but there is a medium sized hernia.  My symptoms begin about 2 hours after falling asleep.  I wake up with tremendous pain and pressure in the left side of my chest, pounding heart and this happens EVERY NIGHT for the last 8 years.  I can go back to sleep after an hour or so of sitting up, but after 2 hours of sleep it starts all over again.

My heart doctor finds no problems with my heart, and I've also heard the same story from several gastro doctors, "this isn't life threatening".  Yeah, right.  I've tried every antacid medication there is and have found no relief from any.  I do have a surgeon that recommends the wrap surgery to repair the hernia.  I have avoided this but am ready to try anything.  Most doctors have no solution to offer at all.  I'm 63 years old, not overweight, don't smoke or drink, so this is also confusing the doctors.  Anyone out there had success with the wrap surgery?
Charles
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Avatar universal
My 2 cents -- in the interest of "giving it a name" I'll mention "Roemheld Syndrome" -- it may have been mentioned on the board before or I may have first read about it elsewhere -- regardless its talked about on the internet - from what I can gather its a real theory (developed by Drs in Germany) that attempts to tie gastric pressure, hernias etc to cardiac symptoms and does so by walking through a common sense cause and effect of pressure on the diaphragm leading to cardiac displacement and irritation that drives symptoms (pvcs etc)  I don't know what kind of supporting research/literature there is but I wanted to get the ball rolling.  Godspeed.

http://en.wikipedia.org/wiki/Roemheld_Syndrome
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Avatar universal
I can't believe I am reading this... I was diagnosed with a hiatal hernia in 2007 and have had PVC's since a little before that. I always kinda thought that there might be a link between the two, but when I have asked my dr's about it, they say there is no link. I am 30 yrs old and I experience them daily and sometimes I have several in a minute that make me feel really sick. I am worried about my health, and can't seem to get any help from my dr's as they think that my PVC's aren't life threatening...
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Avatar universal
I have pvc's, pac's, and was recently diagnosed with SVT.  All triggered by eating and my hiatal hernia.  Dr's dont have a clue and just want to ablate.

I can't believe they don't see the correlation.  All you have to do is google hiatal hernia and arrhythmia!  Or vagus nerve and arrhythmia.

GI Dr's won't communicate with EP Dr's and it all ends up being a waste of time.  Western medicine is still in the dark ages.

If anyone ever comes up with a cure for this let me know.  I have eliminated caffeine, wine, spicy foods, and am now practicing good food combining.  Mostly protein and veggies and rice, some fruit.

Be well all.
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170935 tn?1225371076
My story is similar to filmfanatic's. I can suffer from pvcs, pacs and svt. In fact all my svt episodes are triggered by gas/acid when i am eating!! I am lucky as my GP, cardiologist and EP all AGREE that my heart problems are linked to indigestion symptoms. I have not been diagnosed with hiatal hernia but can suffer from acid reflux and i have IBS.
Anxiety and stress or even colds and flus all irritate our digestive systems and trigger pvcs for me. I find my bad bouts of digestion problems always follows one of these triggers.
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Avatar universal
you are lucky that all your docs agree! I suffer from chronic indigestion, and went to the dr. last yr with palps. After labwork, ekg, and echocardiogram my dr. told me I was just "wired wrong" and that sometimes heart palps can occur. he suggested beta blocker, which I don't want to take because of the side effects. I told him about my indigestion. He didn't make any connection, just gave me Prilosec for that. What did your docs suggest or give you to alleviate the pain or palps?
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667923 tn?1421462724
I understand where ur coming from because I have the same problem. Everytime I eat, I can feel pains in my heart area.Sometimes, they are just like a feeling of something dropping on me like a crumb, but it kinda stings. Then, I have them right over my heart like a pinch or something of that nature. My PCP has put me on a Beta-Blocker and had it at home a month b4 took even one. I went back to see him and told him that I wasn't taking the BB, but I did some research on it and even musicians take a BB, b4 a concert to ease the nervousness.
I just was wondering @ the side effects u were mentioning. What kind of side effects. I am already taking enough medicine now for what I have.Dx with: DDD of cervical,lumbar,hip/joint, Spondylosis,Spinal stenosis,Cm,VA, Fibro,Migraine and my NS is thinking @ adding Myeomalcia..GREAT..U think, it is that or my heart?
They have me on Fentanyl Patch 50mcg,Gabapentin(Neurontin generic),Norco(like lortab 10),Prilosec for my ulcer, but feel the nexium done better 4 me, Xanax for spasms, lasix for swelling/water retention and now my heart is acting up and wondering if it isn't ALL the medicine that I do take. I have cut my patch back from 75 down to 50, and they have me taking 9-300mg. of Gabapentin a day. I just take so much medicine, to have to take something 4 my heart too. I have been dx with a hietal hernia and ulcer back in '94,but have never had much of a problem with it...until NOW. I am wondering if all of this medicine has caused the heart problem??
I am experiencing episodes to where my whole left side of body is completely numb and my heart will race so fast. Resting it has been 111 and I have never had a problem with my <3. I sure hope that those German docs will get us help in this department and can find some kind of correlation between the two. I know that there is one...I can feel it and I know everyone here agrees that when we eat...we pay.
Last night I had to go to get a check cashed and I began to hurt in the center of my chest where the soft spot is and I couldn't even touch it, it hurt so bad. I drank water and it barely soothed it and I didn't know what to do. Of course, with all that is going on in my body..it is a wonder that I am still around and I am only 45.
I just wanted this thread to continue because it spells out THE PROBLEM so many people have..THEY NEED TO FIX THIS PROBLEM and soon.
Take care ALL and God Bless...always:))))<3 Karen
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1423357 tn?1511085442
I too have a hiatal hernia, although I don't know how long I've had it.  I also get PVC's even after my ablation for SVT.  In recent months, I've went on a diet, cut out carbs to about 50g/day, lost 20 pounds, and my PVC's have vanished.  Another thing I've noticed is the heartburn I always had and for which I took Ranitidine for has gone away as well.
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98523 tn?1322074646
same thing happens to me
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Avatar universal
i knew it!!!!, and im glad to hear you guys, atlease i know now that im right. drs did dx hiatal hernia when i was 18 years old and   STV when i was 24,  also had ablation but im still having palps,  specially when i bent over to pick up something from the floor and my lungs are emty, not sure about the palps triggered by breathing but i have seen a relation.  also want to mention that i used to be a competitive cyclist which i think caused in some way all this problems due to abdominal/torax  pressure.  
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Avatar universal
i knew it!!!!, and im glad to hear you guys, atlease i know now that im right. drs did dx hiatal hernia when i was 18 years old and   STV when i was 24,  also had ablation but im still having palps,  specially when i bent over to pick up something from the floor and my lungs are emty, not sure about the palps triggered by breathing but i have seen a relation.  also want to mention that i used to be a competitive cyclist which i think caused in some way all this problems due to abdominal/torax  pressure.  
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Avatar universal
I'm male; I'll be 30 in a few months. I've been living with PVCs/PACs for several years now. They were first diagnosed when I was about 21. A holter monitor recorded that I was having about 4000 abnormal beats per day. This persisted for 6 months to a year. Then, one day...they suddenly seemed to vanish, with no changes to lifestyle.

A few years later, I was having issues with swallowing, heart burn, post nasal drainage, etc., so I got an endoscopy. That test showed a hiatal hernia, eosinophilic esophagitis, and laryngopharyngeal reflux (Silent Reflux/LPR). I did not make the connection at the time, but only a few months after being diagnosed with these throat/stomach issues, I began having palpitations again.

I went back to a new cardiologist, specifically an electrophysiologist, who concluded that my palpitations were PACs. At the time of this second holter monitor, it registered only around 700 in the 24 hour period. It has been about 6 months since this most recent monitor, and I feel like they are more frequent than 700 per day. I seem to notice every, single, weird heartbeat, and I feel them about 3 per minute. There are occasions I can block my mind from focusing on them, but any time I do notice them, it is around the same 3 per minute, roughly one every 20-50 beats. If this is really the typical rate for me, then I am once again having around 4000 per day.

Again, there have been no significant lifestyle changes. There was a period of time shortly after the PACs returned that I was in anxiety-overdrive mode... I was having panic attacks and sleepless nights over the abnormal heartbeats. Getting tests done and being told, "Your heart is structurally normal and healthy," alleviated some of the stress and anxiety, but even still they persist.

I have since tried taking some chelated magnesium supplements, but with no noticeable effect. I have practically eliminated caffeine, having only a single caffeinated beverage every few days. I even tried cutting caffeine out completely, and it didn't seem to make any difference. I have never smoked, been a user of alcohol or drugs, I take no prescription medications, my job is fairly active, essentially a mild 5 hour cardio workout every work day, with some moderate lifting involved, my life is, for the most part, fairly stress-free.

Plainly speaking, I have tried everything most doctors and professionals suggest for symptom relief, all to no avail. One of the only remaining connections to be made is the hiatal hernia/stomach/throat issues.

One other possible connection could be the following:

I have been doing a lot of research into this issue of PACs and PVCs, and I have found certain pieces of evidence that suggest poor posture and spinal alignment can also lead to heart rhythm issues. Specifically, spinal conditions that cause pressure upon the vagus nerve. Some people have found correlations between misalignment of their Atlas vertebra and their irregular heartbeats. There is a treatment known as Atlas Profilax, which can be performed by a chiropractor, which helps to naturally realign the Atlas vertebra through massage. Through this treatment, pressure upon the vagus nerve can be relieved, and related symptoms alleviated.

Being someone that spends much free time playing games on the computer, it is completely possible that my posture has led to a pinched or otherwise impaired vagus nerve, which could thus be causing my palpitations. It should be mentioned that this is more likely the case for people with other symptoms that are also linked to a vagus nerve impairment, such as swallowing problems, numbness or tingling in fingers, and poor digestion (possible link to GERD or LPR, also?), all of which I have.

However, I felt it was still worth mentioning, since some seem to find an amount of relief through Atlas realignment. Perhaps a more in-depth look at the connection between spinal/nerve issues and irregular heart rhythms is warranted. Perhaps some of you suffering from such symptoms would find benefit in discussing Atlas/Vagus treatments with your doctors.

(As a side note, some chiropractors also offer massage treatments that are claimed to help reposition the stomach, effectively resetting a hiatal hernia to a more natural position. I have never had any of these treatments done, but I am considering them heavily. After all, I doubt a massage could be anything but helpful, even if it only serves to relieve muscle tension. Still a positive effect, in the end.)
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