Neurological or cariodovascular?

[JMorgan]

28 year male, never really had any medical problems, normal weight, exercise regularly.  For te past year been getting 3 things that bother me.  

1.  Get sick in my stomach(directly below my breast bone) Makes me not want to eat.  Feel like I want to throw up, but never do.  Not as bad as Nausea, but uneasy feeling.
2.  Feel a burning sensation over my body, typically at the ends of my fingers, or toes.  One toe at a time, one finger at a time, then I'll feel it in my head, then ears.(Not limited to side)
3.  Palps(Skipped beat, followed by extra hard beat)  They come while laying on right side, cough, laugh, bend down, push out a hard stool, etc.  Not while exercising.  Don't feel tired, sweaty, any other symptoms.
All 3 things happen every day.  Palps 3-4 times a day, and burning sensation 5-6 times a day.

Don't  have much stress, anxiety, drink no caffeine, etc.  Very normal overall.

I've had the million dollar workup as my Dr stated, with EKG's, Echo Stress Tests, Upper GI, C-Spine's Brain MRI's w/wo contrast, EMG's, 24 hr Holter, tons of blood work, etc... but nothing shows up.  Also been to an IM, Neuro, and Gastro Dr.

To me they all seem related, because I've never had any of these problems, and they all showed up a year ago at the same time, and have yet to go away.  

Suggestion on if this would be cardio or neuro?  Wondering if my palps come from neurological, because they come at weird positions.  Anything neurological cause all of these all at the same time?

Personally think Lyme, but was tested for that with a Titer.

[Pum]

Palps are common and mine are like yours, caused by valsava manoevres (straining, coughing.) They're normal but lots of people don't notice them.
The tingling could be a back thing or a breathing thing.  Make sure you are breathing from your stomach not your chest.
The below breastbone sounds like nausea caused by stomach complaint rather than illness.
Now I have had all three of these things and they were caused by depression/anxiety.  Not saying this is the case for you but keep it in mind.  Are you sleeping normally, eating normally?  These are the first things to go (I loose a lot of weight and wake early and sleep in the daytime.)
If not that then try not to worry, you have had a great work-up.  

[Adrienne]

celiac and b-12 definitely good ideas. another few i thought of was something called chiari malformation which is a disorder that affects where the brain meets the spinal cord causing some sort of compression of sorts which can cause all sorts of symptoms including GI disorders, heart palps, neuropathy/tingling/numbness in the extremeties and other locations along with various other things. An MRI of the base of the brain and neck needs to be done to check for this and some drs dont look for this specific problem so need someone who knows what they are looking for. Also there is spinal stenosis and some other spinal problems which could contribute too. The heart could be checked out too for different problems. A holter monitor could be ordered to see if there is an irregular heart beat or something during the palps. Also with checking for gastroparesis see a GI specialist who could order something called a gastric emptying study. Neuro might also be able to due nerve conduction studies to rule out neuropathies. Another disorder called dysautonomia can cause a wide array of problems including some you mentioned. I would definitely try and find a good cardio, neuro and gastro and get them all working together on this to find an answer. Good luck!

[JMorgan]

Thanks for the insight.  I did have a test for the B-12 and Celiac, which were both ruled out, but I'll definitely look into the gastroparesis.  Never heard of that one before, so I'm curious.  The other thing that I forgot to mention, don't know if it has any impact, but since I was having all of these weird sensations, I went to a Chiro, and the palps started happening the day after I went.  Don't know if there could be a correlation or not, but thought I'd mention it.

[Annie62]

You might want to read up on both B12 deficiency and celiac disease.  Both can cause stomach pain, paresthesias (numbness, tingling, burning sensations-as you mentioned), and palpitations.  Both can cause neurologic symptoms.  There are blood tests for both.  B12 defic. can be due to either a vegan/mostly vegan diet or pernicious anemia.  Also, being on PPIs (AciPhex, Protonix, Nexium, etc.) chronically can make it harder for the stomach to absorb B12. (I'm mostly vegan and also am on PPIs twice a day and my B12 recently was in the low-normal range-not enough to cause symptoms, though.)  Celiac disease is fairly common, too, and can cause neuro symptoms (including autonomic neuropathy) as well as the gluten intolerance/stomach issues.  

Also, if you have a feeling of pressure below your sternum/epigastric area and feel sick/nauseated along with stomach pain, you might have something called gastroparesis.  It's not that uncommon, especially when mild or moderate.  I have had neuropathy for 17 years-still unknown origin/being worked up for it-and found out 7 months ago I have gastroparesis.  I was having lots of reflux, stomach/chest pain, nausea and a bloating/pressure-feeling, like my stomach was shoved up into my chest, especially after eating.  I went for an EGD, my stomach was full of food residue so I got sent for a gastric emptying scan which showed severe gastroparesis.  So if it is severe it can sometimes be picked up on EGD/endoscopy (you mentioned you had an upper GI-can't remember what, though), but usually it needs to be dxd with a gastric emptying scan.  It is usuallly caused by autonomic neuropathy (vagal nerve damage) and seen with diabetes but also with lots of other conditions, neurologic and otherwise.  So, those are three things you might want to read up on or ask your doctor about.