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I Have Had Several Cardiac Issues Over The Years Including

Posted on Thu, 6 Jun 2019

Question: I have had several cardiac issues over the years including a double bypass, an ablation, an inversion, several stents and a pacemaker installed due to being bradycardic, After the latter was put in, I noticed that when I lay down on either side, I would feel pressure on my chest after a few minutes and my heart rate would go from 60 to 93 then go away several minutes later. The same holds true when I bend over wrong or swallow hard. My cardiologist said not to worry because my heart rate is fine but it is very uncomfortable. Someone even suggested that it had something to do with my vagus nerve. Any help would be appreciated as it has not gone away in 6 months.

Answered by Dr. Ilir Sharka (2 hours later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

I understand your concern and would explain that these heart rate fluctuations could be related to the vagal nerve stimulation.

But, we can not exclude possible paroxysmal atrial fibrillation, based on your description.

For this reason, I would recommend performing an ambulatory 24-48 hours ECG monitoring in order to examine better your heart rhythm trends and exclude possible cardiac arrhythmia.

You should discuss with your doctor on this test.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Ilir Sharka, Cardiologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (3 hours later)

Thank you for your response. The other thing I notice is that when I have gas in my stomach, the pressure builds on my chest and again the heart rate picks up. When I belch to relieve it, it then goes away in a few minutes. Back in 2007, I had a hiatal hernia and from time to time I have trouble with food going down, almost as if it gets stuck in my chest area.

Answered by Dr. Ilir Sharka (2 hours later)

Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Yes, a hiatal hernia could mimic this clinical situation too.

For this reason, I would recommend avoiding spicy food and trying to eat more frequently and in small portions.

Anyway, a prolonged ECG Holter monitoring would help examine better your heart rhythm trends and exclude possible cardiac arrhythmia.

Hope to have been helpful!

Wishing good health,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (2 days later)

Is there anything I can do to keep my heart from racing when I lie down after a few minutes? Also if I have to swallow hard, it seems to trigger a reaction that my heart again races for about a minute or so, then calms down,

Answered by Dr. Ilir Sharka (4 hours later)

Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

I understand your concern and would explain that there is not too much to be done during this clinical situation.

I would just recommend close your eyes and take some deep breaths.

Regarding the hard swallowing and the heart racing, it could be related to an autonomic reaction (vagal and sympathetic system stimulation). It may be considered an exaggerated physiological reaction in a sensitive person.

Hope you will find this information helpful!

Wishing all the best,

Dr. Iliri

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar