[50F] Experiencing heart palpitations, acid reflux, and other symptoms

Patient Description

A 50-year-old female presents with heart palpitations that occur mostly at night, described as fluttering and sometimes a thump, persisting for a month. The patient also suffers from acid reflux for 8 years, with symptoms including a sensation of liquid regurgitating into the esophagus, chest pain, and throat constriction, which are exacerbated by alcohol and post-coughing. The patient manages the reflux by sleeping inclined and massaging the area. Additionally, the patient reports occasional right kidney pain, reminiscent of past kidney stones, and smelly urine. The patient also notes new-onset blurry vision, described as objects being out of focus. The patient is currently taking Prilosec and various over-the-counter supplements, including a probiotic, lysine, a multi-vitamin, magnesium citrate, collagen peptides, and Estroven. There is no known history of allergies or adverse reactions to medications, and no other chronic illnesses or pre-existing conditions were reported.

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Arora's Assessment

What might be happening

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

  • Gastroesophageal Reflux Disease (GERD): This is a 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 and cause symptoms like heartburn and chest pain. It can also cause a feeling of a lump in your throat.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor may recommend prescription medications or even surgery.
  • Heart Arrhythmia: This is a condition where the heart beats too fast, too slow, or with an irregular rhythm. Heart palpitations, where your heart feels like it's pounding, racing, or fluttering, can be a symptom of heart arrhythmia.

    • Treatment depends on the type and severity of the arrhythmia. Some arrhythmias may require no treatment, while others may require medication, lifestyle changes, or even surgery.
  • Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. Kidney stones can cause severe pain in the side and back, below the ribs. The pain may also come in waves and fluctuate in intensity.

    • Treatment depends on the type of kidney stone and its cause. Small stones with minimal symptoms can be treated with drinking water, pain relievers, and medication to help pass the stone. Larger stones may require more invasive treatments.
  • Urinary Tract Infection (UTI): This is an infection in any part of your urinary system, which includes your kidneys, bladder, ureters, and urethra. UTIs can cause a strong, persistent urge to urinate, a burning sensation when urinating, and strong-smelling urine.

    • Treatment typically involves antibiotics to kill the bacteria causing the infection.
  • Presbyopia: This is the gradual loss of your eyes' ability to focus on nearby objects. It's a common condition as you age, usually becoming noticeable in your mid-40s and continues to worsen until around age 65. Symptoms include blurred vision at a normal reading distance and eyestrain or headaches after reading or doing close-up work.

    • Treatment can be as simple as buying over-the-counter reading glasses. If these aren't enough, your doctor can prescribe glasses or contact lenses. Surgery is also an option.

What you can do

  1. For GERD, try to avoid foods and drinks that trigger your heartburn, such as alcohol. Also, try to eat smaller meals and avoid eating 2-3 hours before bedtime.
  2. For heart palpitations, try to reduce stress and anxiety as these can trigger palpitations. Regular exercise and a healthy diet can also help.
  3. For kidney stones, drink lots of water to help flush out the urinary system. Also, try to avoid foods high in oxalates, such as spinach, rhubarb, nuts, and wheat bran.
  4. For UTIs, drink lots of water to dilute your urine and help flush out bacteria. Avoid drinks that may irritate your bladder, such as coffee, alcohol, and soft drinks containing citrus juices or caffeine.
  5. For presbyopia, try using reading glasses. If your vision continues to worsen, consult an eye doctor for a prescription or to discuss other treatment options.

What you should look out for

  • If your heart palpitations are accompanied by shortness of breath, chest pain, fainting, or severe dizziness, seek medical attention immediately as these could be signs of a serious heart condition.
  • If your acid reflux symptoms worsen or don't improve with treatment, consult a doctor. Long-term GERD can cause complications, such as damage to the esophagus.
  • If your kidney pain is severe or if you have blood in your urine, seek medical attention immediately. These could be signs of a large kidney stone or a kidney infection.
  • If your UTI symptoms persist after treatment, consult a doctor. UTIs can lead to serious complications if not properly treated.
  • If your vision continues to worsen or if you experience sudden vision loss, seek medical attention immediately. These could be signs of a serious eye condition.

Please remember that while I strive to provide accurate information, I am an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common triggers for GERD and how can they be managed?

Common triggers for GERD include spicy foods, alcohol, caffeine, and large meals. Managing GERD involves avoiding these triggers, eating smaller meals, not lying down immediately after eating, and elevating the head while sleeping. Over-the-counter medications like antacids can also help.


What should I do if I experience heart palpitations at night?

If you experience heart palpitations at night, try to reduce stress and avoid stimulants like caffeine and nicotine. Practice relaxation techniques before bed. If palpitations are accompanied by chest pain or dizziness, seek medical attention.


How can I differentiate between kidney stones and a urinary tract infection?

Kidney stones often cause severe pain in the side and back, while a UTI typically causes a burning sensation during urination and frequent urges to urinate. Smelly urine can occur in both conditions. A healthcare provider can perform tests to differentiate between the two.


What are the treatment options for presbyopia?

Presbyopia can be treated with over-the-counter reading glasses or prescription lenses. If these are insufficient, consult an eye doctor for other options, such as bifocals, contact lenses, or surgical procedures like LASIK.


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