[22M] Experiencing heart palpitations and tightness after eating

Patient Description

A 22-year-old male reports heart palpitations that begin approximately 5 minutes after eating and can last from 30 minutes to an hour. The palpitations are described as a racing heart rate without pain but are accompanied by shortness of breath, a feeling of fullness, and occasional dizziness. These symptoms seem to improve with burping. The patient also experiences brief, mild chest pain rated 2 out of 10, which is worsened by rotating the shoulder. There is no history of chest pain associated with the palpitations, no recent use of caffeine, alcohol, or other substances, and no known allergies or adverse reactions to medications. The patient is not on any medications and has no known pre-existing conditions or chronic illnesses. Stress levels have been high, which may be contributing to the symptoms.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Gastroesophageal Reflux Disease (GERD): This is a common condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus. Symptoms include heartburn, chest pain, and a sensation of a lump in your throat. You mentioned that your symptoms get better after you burp, which is a common symptom of GERD.

    • Treatment typically involves lifestyle modifications such as avoiding certain foods and beverages, eating smaller meals, not lying down for at least three hours after eating, and maintaining a healthy weight. Over-the-counter or prescription medications may also be recommended.
  • Anxiety/Stress: You mentioned that you have been under a lot of stress for the past two years. Stress and anxiety can cause a variety of physical symptoms, including heart palpitations and digestive issues.

    • Treatment often involves a combination of lifestyle modifications, therapy, and medication.
  • Postprandial Hypotension: This is a condition characterized by a drop in blood pressure after eating, which can lead to dizziness and heart palpitations.

    • Treatment typically involves dietary changes, such as eating smaller, low-carb meals and drinking water before meals.

Please note that these are just possibilities and not a definitive diagnosis.

What you can do

  1. Try lifestyle modifications such as avoiding spicy and fatty foods, eating smaller meals, not lying down for at least three hours after eating, and maintaining a healthy weight to see if your symptoms improve.
  2. Practice stress management techniques such as deep breathing exercises, yoga, and meditation.
  3. Make an appointment with your doctor to discuss your symptoms. They may recommend further testing to determine the cause of your symptoms.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe chest pain or discomfort
  • Trouble breathing
  • Fainting
  • Sudden dizziness
  • Rapid or irregular heartbeat

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare professional for an accurate diagnosis.

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9 mo ago


People Also Ask


What are heart palpitations and what causes them after eating?

Heart palpitations are feelings of having a fast-beating, fluttering, or pounding heart. They can be caused by various factors, including the body's response to eating, especially if the meal is large or high in carbohydrates. This can stimulate the vagus nerve, which affects heart rate.


How can stress and anxiety contribute to heart palpitations and digestive issues?

Stress and anxiety can trigger the body's 'fight or flight' response, releasing hormones like adrenaline that can increase heart rate and cause palpitations. They can also affect digestion, leading to symptoms like bloating and discomfort.


What is Gastroesophageal Reflux Disease (GERD) and how can it be managed?

Gastroesophageal Reflux Disease (GERD) is a condition where stomach acid frequently flows back into the esophagus, causing irritation. It can be managed with lifestyle changes such as avoiding trigger foods, eating smaller meals, and not lying down after eating. Medications may also be prescribed to reduce acid production.


What is postprandial hypotension and what dietary changes can help manage it?

Postprandial hypotension is a drop in blood pressure after eating, which can cause dizziness and palpitations. Managing it often involves eating smaller, low-carbohydrate meals and drinking water before meals to help maintain blood pressure levels.

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