
What Causes Persistent Heart Palpitations And Acid Reflux?

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Detailed Answer:
Hello and Welcome
I have read your history carefully.
I very much appreciate your concern.
Let me address a few issues that may help you focus on the solutions.
Based on your BMI , which I calculated via weight in kg divided by Height in meters squared, which came out to be around 41.05 which is very high.
Lorcaserine is indicated in a BMI of > 30 Kg/meter squared if there is also a weight related co morbid condition like hypertension, dyslipidemia, Diabetes. so if you fit the criteria, You may discuss this option with your doctor to help you loose weight effectively.
The GERD issue especially with the recurrence despite the Hpylori treatment, needs to be addressed in more than one ways. Firstly, a high dose empiric therapy is standard of care in most guidelines before invasive investigations are done. A useful and common regimen which I use in my clinic is Esomeprazole 40 mg bd, itopride 50 mg tds, sucralfate tds, Bismuth subsalicylate tds.
If despite a two week treatment the symptoms persist and endoscopy is clear, then you may go for 24 hour PH monitoring to confirm GERD.
Diet changes are necessary.
Diet changes are quite simple that you need to make. Do not complicate them by following complex regimens. Take 5 small meals a day consisting mainly of low carbohydrates , high fiber and low fat ingredients. Participate in 30 minutes of exercise twice daily. Avoid cola, caffeine, ice cream and over processed food as much as you can. Avoid eating after 9 PM at night. Keep a diet diary to record your daily routine for it to make a habit to see how you respond and what progress you make along the way.
The palpitations , esp that the EKG etc are clear indicate panic attacks. Propranolol is better than metoprolol in this regard. you may observe your sleep patterns to see if you have insomnia and may take lorazepam 1mg at night for two weeks to regularize your sleep and overall calm yourself down.
I would suggest you consult a psychiatrist
so that a XXXXXXX mental state exam is performed.
to ascertain depression and or anxiety,
Meds can be adjusted afterwards in addition
to cognitive behavioral therapy. Yoga and meditation ,
too have proven benefit n addition to relaxing exercise.
Let me know if you have any query
wishing you best of health
Thanks

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