Rare and unusual presentation of gastrocardiac syndrome

I have to say that in all my 3 episodes of Afib, there was 100% a gastric connection, that sensation of my stomach being full-blooded. Today I went to talk about this with my Primary, and of course he negated the possibility out of his ignorance, and to talk about this with the EP.

For those who have or think have the gastrointestinal connection to Afib, this is a good study to read in full


Abstract
Gastrointestinal pathology can cause cardiac symptoms and disorders. We present a case of a patient who had worsening of her palpitations with food intake. She was found to have a high burden of premature ventricular contractions in the setting of hiatal hernia and gastro-oesophageal reflux disease. After extensive investigations and ruling out cardiac causes, her arrhythmia resolved with the surgical correction of hiatal hernia.


[www.ncbi.nlm.nih.gov]



Edited 1 time(s). Last edit at 08/24/2023 03:31AM by Marco.

this is a Radio Podcast about the Roemheld Syndrome: The Gastric - Cardiac Connection. I don't believe they mention Afib, but PVC's and tachycardia for sure.


[superhumanradio.net]

My gosh Marco, thanks! I’ve been complaining for decades about my Afib and GERD being so bad I still get acid vomiting plus being anemic (getting iron iv), pain in my chest and bowel obstruction. Nobody connected the possibility of a hiatal hernia. All my complaints went to deaf ears. Multag made it worst and I would just get Afib after vomiting acid. My GP, GI and cardiologist suggested GERD and “stable angina” diagnosis and handed out nitro and Prilosec.

It’s a tragedy now after my AV nuke ablation but “what if” someone made the connection?

Yes, in this compilation from 2007 of members' methods of controlling afib, quite a few had a digestion connection.

Here is a list I put together in 2011 of those with a GERD/afib connection.

Member Dean still posts here and found that consumption of natto food was his solution.



Edited 1 time(s). Last edit at 08/24/2023 12:45PM by GeorgeN.

I just want to make a note for someone who may read this.

GERD and gastrointestinal mobility issues may point out to a suboptimal thyroid and adrenal function.

Quote
susan.d
My gosh Marco, thanks! I’ve been complaining for decades about my Afib and GERD being so bad I still get acid vomiting plus beish ng anemic (getting iron iv), pain in my chest and bowel obstruction. Nobody connected the possibility of a hiatal hernia. All my complaints went to deaf ears. Multag made it worst and I would just get Afib after vomiting acid. My GP, GI and cardiologist suggested GERD and “stable angina” diagnosis and handed out nitro and Prilosec.

It’s a tragedy now after my AV nuke ablation but “what if” someone made the connection?

I hear you Susan. It is very frustrating going to speak with most doctors. How I do, is I go talk to them, see if they are able to work with me and see what they can offer, otherwise I'll try to find someone else. It is very challenging to find a "decent" doctor who takes health insurance. The rest of them take cash.

Quote
Marco
I just want to make a note for someone who may read this.

GERD and gastrointestinal mobility issues may point out to a suboptimal thyroid and adrenal function.

Quite a few posters I remembered in the past 19+ years I’ve been on this forum commented they got afib from dysfunctional thyroid issues or meds for their problem.

My GP, who I called a medical Sherlock Holmes, did extensive labs and referred me to a Thyroid specialist because I developed afib. All labs came back normal and he repeated the test every 3-6 months. My GP concocted a neck soup broth from chicken and turkey necks, his speculation was whatever leached into the soup is better than taking thyroid meds.

It just so happens I just finished making my neck broth (I refrigerate and remove fat before drinking using this bag: [www.amazon.com] ) just now using my Ninja Foodi. Its pressure cooker cooked the broth in ten minutes. I buy “Souper cubes” on Amazon ( [www.amazon.com] ) and freeze my batches so I can always pop a frozen soup cube and heat it up whenever I want soup. I am a big fan of homemade natural no added salt soup.

[livhealth.com].

I think hereditary plays in. My mom had afib plus her afib was exasperated by her thyroid meds. I prefer my natural neck broth approach vs drugs. It’s hydrating and fills me up.



Edited 1 time(s). Last edit at 08/24/2023 09:26PM by susan.d.

Any first hand experiences with manual manipulation to fix a hiatus hernia?

I am not an expert, but I believe it is safe to say that the only 'fix' for an HH is surgery. With mesh. In fact, I think you'll find that a doctor would strongly caution you against manipulating an HH in attempt to rectify it, or at least to push the protruding bowel segment back through the gap. I think that might be inviting all sorts of trouble.

Again, I'm not a physician.

I’m getting tested in less than two weeks to see if I have it. The horse already left the gate (since I’m av nuked) but it will give me closure on why I couldn’t get “fixed”. They are starting with a CT with contrast and then a endoscopy.

I will say Multaq aggravated my GERD because one of its listed side effects is acid reflux. I am no longer on multaq or any arrhythmia drug but I still vomit acid if I eat all foods that are dry like chicken, bagels etc. After starting multaq was when my frequent afib and flutter occurred after eating and getting acid buildup..or laying in bed. Two bed wooden posts (they sell them) at the front of the bed’s two legs helped in the states but I didn’t pack them unfortunately to where I now live.

I don’t like Prilosec but my new GI wants me on two a day to see if it lowers my AFib burden. I am not concerned about afib, just the symptoms of being out of breath and a pounding >300hr atrium even though my ventricles are paced to beat at 60. I take a PIP (EP instructions) of Cardizem to lower my hr. It usually, with PM burst therapy, puts me back to temporary nsr and I get a break for awhile.

Thank you Marco!!

I misspoke about the bowel in my previous reply. Of course an HH is quite a bit distant from the bowel. Or at least, we should all hope so.

Quote
susan.d
I’m getting tested in less than two weeks to see if I have it. The horse already left the gate (since I’m av nuked) but it will give me closure on why I couldn’t get “fixed”. They are starting with a CT with contrast and then a endoscopy.

I will say Multaq aggravated my GERD because one of its listed side effects is acid reflux. I am no longer on multaq or any arrhythmia drug but I still vomit acid if I eat all foods that are dry like chicken, bagels etc. After starting multaq was when my frequent afib and flutter occurred after eating and getting acid buildup..or laying in bed. Two bed wooden posts (they sell them) at the front of the bed’s two legs helped in the states but I didn’t pack them unfortunately to where I now live.

I don’t like Prilosec but my new GI wants me on two a day to see if it lowers my AFib burden. I am not concerned about afib, just the symptoms of being out of breath and a pounding >300hr atrium even though my ventricles are paced to beat at 60. I take a PIP (EP instructions) of Cardizem to lower my hr. It usually, with PM burst therapy, puts me back to temporary nsr and I get a break for awhile.

Thank you Marco!!

Of course. I'm glad you were able to schedule everything so quickly. My GP last week really didn't want to help. I'm going to see my EP in two weeks, let's see if he wants to investigate this, otherwise I will need to find another doc.

The first time I went into Afib, an antiaging doc told me that he believes most Afib is related to gut health.

Keep me posted.

Gut microbiome and atrial fibrillation—results from a large population-based study


Conclusions
In conclusion, we observed a different microbiome composition in prevalent and incident AF compared to non-affected individuals with a number of genera and species which differed in abundance. Overall, the alpha and beta diversity of the gut microbiome did not meaningfully discriminate individuals with prevalent or incident disease. Machine learning methods optimized for binomial discrimination and use of species (or even higher) resolution level may be required to improve our understanding of the role between AF and gut microbiome. The shift of the bacterial composition towards a spectrum with similarities to the microbiome in hypertension and heart failure highlights a shared underlying pathophysiology. It still remains unknown whether modulating the intestinal microbiome and metabolism offers new approaches to primary, secondary or tertiary prevention of AF, and whether tracking the gut microbiome composition may help to guide lifestyle interventions and management in AF patients.



[www.thelancet.com]

Quote
Marco
Conclusions
In conclusion, we observed a different microbiome composition in prevalent and incident AF compared to non-affected individuals with a number of genera and species which differed in abundance. /quote]

Some years ago (5?), my wife & I were consulting with our "longevity" doc. Independently, we'd gotten a stool sample test of our fecal microbiome. He told us not to bother spending our money on this. He'd been at a conference and a paper presented showed huge differences in results depending on where on the stool the sample was taken. Like from the outside of the stool, the core and other combinations. He said the whole methodology wasn't there yet to get meaningful info.

Also, we really don't know about anaerobic bugs as they don't live outside the gut. My understanding is that most of the bugs in the small intestine are anaerobic.

So not saying they aren't important, they likely are very important. We just don't know how to figure it out yet.

As an aside, I tend to run low white blood cell count. While it can mean many things, I'm totally asymptomatic and he said it was a good (and cheap) indicator of "leaky gut." Likely LPS (lipopolysaccharide) in my serum.

Quote
GeorgeN

Conclusions
In conclusion, we observed a different microbiome composition in prevalent and incident AF compared to non-affected individuals with a number of genera and species which differed in abundance. /quote]

Some years ago (5?), my wife & I were consulting with our "longevity" doc. Independently, we'd gotten a stool sample test of our fecal microbiome. He told us not to bother spending our money on this. He'd been at a conference and a paper presented showed huge differences in results depending on where on the stool the sample was taken. Like from the outside of the stool, the core and other combinations. He said the whole methodology wasn't there yet to get meaningful info.

Also, we really don't know about anaerobic bugs as they don't live outside the gut. My understanding is that most of the bugs in the small intestine are anaerobic.

So not saying they aren't important, they likely are very important. We just don't know how to figure it out yet.

As an aside, I tend to run low white blood cell count. While it can mean many things, I'm totally asymptomatic and he said it was a good (and cheap) indicator of "leaky gut." Likely LPS (lipopolysaccharide) in my serum.

I agree with yor longevety doc. I'm going to post a study that I think it is really worth the reading for anyone who thinks there is a link between Afib and the gut. As I mention before, an antiaging doc I used to consult with, told me that he believes most of Afib is connected with gut issues.



Edited 1 time(s). Last edit at 09/06/2023 03:31AM by Marco.

Marco- looking forward to reading the study

Quote
susan.d
Marco- looking forward to reading the study

Hi Susan, I made a new post with the study, but I will attach the link to it at the bottom of this comment for you.

This is a quote from Hippocrates: "All disease begins in the gut"

This is a study that was recently published
[www.aerjournal.com]

Thanks Marco!
Check out the GERD/CPAP link I just shared in the general forum.

Quote
susan.d
Thanks Marco!
Check out the GERD/CPAP link I just shared in the general forum.

that's interesting. I have been using a CPAP machine for a mild sleep apnea, and I was thinking if there was any connection to it. Thanks for sharing the link

Part of my problem was laziness with using my cpap on vacations. I was on flecainide successfully for 15 years and went overseas for 5 weeks and I didn’t pack my cpap equipment due to lack of carry on and check in space and weight restrictions. My afib came back. So since then I have used it religiously except for this week because it was 105 degrees and I was carrying too much on the super hot bus and train to take my cpap with (needed 3 hands) to a hotel while on vacation —so I left it home like before. I felt the difference during my vacation this week. I was symptomatic. Tonight I’m back home and will be on routine using it.

Quote
susan.d
Part of my problem was laziness with using my cpap on vacations. I was on flecainide successfully for 15 years and went overseas for 5 weeks and I didn’t pack my cpap equipment due to lack of carry on and check in space and weight restrictions. My afib came back. So since then I have used it religiously except for this week because it was 105 degrees and I was carrying too much on the super hot bus and train to take my cpap with (needed 3 hands) to a hotel while on vacation —so I left it home like before. I felt the difference during my vacation this week. I was symptomatic. Tonight I’m back home and will be on routine using it.

check this out, another study pointing out GERD and Afib

[www.ncbi.nlm.nih.gov]

Thanks marco. I’ll print your studies to show the chief at the GI department where I go. I got the CatScan CD but am waiting for the results.

The CT prep was horrible yesterday, I’m allergic to iodine contrast and this country’s protocol is 50mg prednisone 13 hours beforehand, 50mg 7 hours beforehand and then a third 50mg one hour before with a generic Benadryl. Having 150mg prednisone in my system within 13 hours wasn’t fun. I don’t remember any strength in the states that strong for pre medication for an iodine allergy but I just looked it up and the dosage is correct:

[www.mskcc.org].

I appreciate your links you share…maybe too late for me but at least if I can limit the episodes when I’m very symptomatic to dizziness and a pounding chest in the upper chambers which I feel —while my lower chambers are at a steady 60– perhaps it will increase my quality of life if I do have the condition you posted and they can fix it.

The health care is excellent here. I got a bone density test the day before and will schedule a sleep study soon to see if my cpap settings needs tweaking. I’m also scheduled soon for a neurological appointment because I’m getting increased uncontrollably leg spasms since my flecainide overdose.
[www.ncbi.nlm.nih.gov].

Quote
susan.d
Thanks marco. I’ll print your studies to show the chief at the GI department where I go. I got the CatScan CD but am waiting for the results.

I'm attaching two more studies, I may repeat some links I have already showed you, but there is 100% a connection between GERD and Afib, the potential mechanism is explained in the studies. It has something to do with literally pushing/moving one of the heart chambers.

I think the mechanism is in this study below
[academic.oup.com]

this is a good one also
[www.ncbi.nlm.nih.gov]


at the end, I believe diet and hormones are influencing everything, GERD included.



Edited 1 time(s). Last edit at 09/14/2023 12:59AM by Marco.

Quote
susan.d
Thanks marco. I’ll print your studies to show the chief at the GI department where I go. I got the CatScan CD but am waiting for the results.

The CT prep was horrible yesterday, I’m allergic to iodine contrast and this country’s protocol is 50mg prednisone 13 hours beforehand, 50mg 7 hours beforehand and then a third 50mg one hour before with a generic Benadryl. Having 150mg prednisone in my system within 13 hours wasn’t fun. I don’t remember any strength in the states that strong for pre medication for an iodine allergy but I just looked it up and the dosage is correct

is this the preparation for the CT scan that is done to look for the stomach hernia?? 50mg Prednisone is a huge dose! I went to my EP yesterday and he did acknowledged the gastrocardiac syndrome and agreed on the possibility of some gastrointestinal issue triggering my Afib, he wrote a note for my GP to refer me to a gastroenterologist.

I'm in the US as well.

It was an abdominal ct. I’m patiently waiting to hear back on what tests will be done next. An endoscopy for sure for my gerd and in addition a colonoscopy or a sigmoidoscopy to peek to see why I had a GI bleed last year and check on the polyp they saw-something about a tag by the polyp.

I will be bringing printed links you supplied. Thanks again Marco.

Quote
susan.d
It was an abdominal ct. I’m patiently waiting to hear back on what tests will be done next. An endoscopy for sure for my gerd and in addition a colonoscopy or a sigmoidoscopy to peek to see why I had a GI bleed last year and check on the polyp they saw-something about a tag by the polyp.

I will be bringing printed links you supplied. Thanks again Marco.

HI Susan how are you doing?

After all of these months I was able to see a Gastroenterologist, we did an abdominal ultrasound and he believes there should be a small hiatal hernia. He is sending me for an endoscopy

Hello, George - and thanks for bringing the " No More Heartburn" link forward.

My digestive problems of the past remain that way, thankfully... but I continue to use digestive enzymes with meals and betaine HCl with meals containing animal protein, just to be sure.

Be well,
Jackie