Chest Discomfort and Palpitations: Could It Be GERD?

Suspected gastroesophageal reflux disease (GERD) with chest tightness and palpitations?

Hello, doctor.
For the past few months, I have frequently experienced chest tightness and palpitations, along with a sensation of something stuck in my throat (+ mild hand numbness and weakness & slight tinnitus).
I feel worse when lying down.
I also have some gastrointestinal discomfort (a bloated feeling or a sensation of my stomach churning), which occurs both during the day and at night.
I suspect it might be gastroesophageal reflux disease (GERD), but I do not have a noticeable sour taste coming up; instead, I experience an unusual tingling sensation that travels from my arms upwards.
Each time I have an episode, the discomfort in my chest is more pronounced than the gastric discomfort, and sometimes I even feel sharp pain in my chest (on both the right and left sides), which has led me to suspect a heart issue.
I have undergone chest X-rays and an electrocardiogram at a cardiology clinic while feeling well, and there were no abnormalities.
I have been trying to maintain a light diet (mostly rice, vegetables, eggs, and chicken) and have avoided sweets and caffeine, yet the symptoms still occasionally occur.
I would like to ask the doctor if my symptoms could potentially be caused by my stomach (GERD), and whether I need to return to the cardiology department for further examination.
Thank you.

ting, 20~29 year old female. Ask Date: 2016/10/20

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss.
You can either undergo an upper gastrointestinal endoscopy or take (out-of-pocket) acid-reducing medication to see how you respond.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2016/10/20

More Info

Your symptoms of chest discomfort, palpitations, and a sensation of a lump in your throat, combined with gastrointestinal issues, can indeed be indicative of gastroesophageal reflux disease (GERD). However, the overlap of symptoms between GERD and cardiac issues can make it challenging to pinpoint the exact cause without further evaluation.

GERD occurs when stomach acid flows back into the esophagus, leading to symptoms such as heartburn, chest pain, and difficulty swallowing. While you mentioned not experiencing the classic symptom of acid reflux (the sour taste), it is important to note that GERD can manifest in various ways, including atypical symptoms such as chest pain, throat discomfort, and even respiratory issues. The sensation of a lump in your throat, known as globus sensation, can also be associated with GERD, as the esophagus and throat can become irritated by acid exposure.

The presence of palpitations and the feeling of heaviness in your chest can be concerning, especially since they can be associated with both gastrointestinal and cardiac conditions. It is reassuring that you have undergone an X-ray and an electrocardiogram (ECG) without any abnormalities. These tests are essential in ruling out significant cardiac issues, but they do not completely eliminate the possibility of other heart-related conditions, such as arrhythmias or ischemic heart disease, particularly if your symptoms persist or worsen.

Given your symptoms, it would be prudent to consider a few steps:
1. Consult a Gastroenterologist: Since you suspect GERD, a gastroenterologist can perform further evaluations, such as an upper endoscopy or pH monitoring, to assess for acid reflux and its potential complications. They may also recommend lifestyle changes, dietary modifications, or medications to manage your symptoms effectively.

2. Cardiac Evaluation: If your symptoms continue or if you experience new symptoms such as shortness of breath, severe chest pain, or dizziness, it would be wise to return to your cardiologist for further evaluation. This may include a stress test, echocardiogram, or even a Holter monitor to assess for any arrhythmias that might not have been captured during your initial tests.

3. Lifestyle Modifications: You mentioned already making dietary changes, which is excellent. Continuing to avoid trigger foods (such as spicy foods, fatty foods, caffeine, and alcohol) can help manage GERD symptoms. Additionally, consider eating smaller meals, not lying down immediately after eating, and elevating the head of your bed to reduce nighttime symptoms.

4. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare providers in determining the best course of action.

In conclusion, while your symptoms could be related to GERD, the possibility of cardiac issues should not be overlooked, especially given the nature of your chest discomfort and palpitations. A thorough evaluation by both a gastroenterologist and a cardiologist will provide a clearer picture and help guide appropriate treatment. Don't hesitate to seek further medical advice, as early intervention can significantly improve your quality of life.

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