Heartburn May Not Be Such a Misnomer After All

NEW YORK — Heartburn occurs when stomach acid backs up into the esophagus, causing chest pain. Gastroesophageal reflux disease or GERD, as it’s called technically, has nothing to do with the heart … or does it?

Polish researchers report that people with existing coronary artery disease may also have GERD, and this can trigger constriction of the heart’s blood vessels and cause ischemia — restricted bloody supply that can damage the heart further.

However, this chain of events can be prevented with drugs that reduce the production of gastric acid, the team reports in the International Journal of Cardiology.

Dr. Slawomir Dobrzycki from the Medical University in Bialystok and colleagues had 50 patients with proven coronary artery disease undergo 24-hour continuous recording of the acidity in the esophagus and the heart’s electrical rhythm.

Then the 23 patients found to have GERD were given the acid-reducing drug omeprazole to take twice daily for seven days. On the seventh day, the simultaneous ECG and acidity Holter monitoring was repeated.

Overall, 45 (21 percent) of a total of 218 episodes of heart ischemia seen on the ECG recording coincided with episodes of acid reflux. GERD patients had significantly more ischemic events.

However, by comparing the recordings obtained before and after treatment with omeprazole, the researchers concluded that the anti-reflux therapy reduced the amount of ischemia suffered by the heart.

They say a “multidisciplinary approach” to evaluating patients with chest pain should be able to uncover the underlying problem and lead to the best treatment.

SOURCE: International Journal of Cardiology, September 15, 2005.