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32 M, for the better part of a year now I cannot stand up without having heart palpitations.

Sex: Male
Age: 32
Height: 195cm (6'5")
Weight:102kg (230lbs)
Medication: Betaloc Zok
Any known illness: No
Drugs: No

T L D R -- When I get up from a lying/sitting position I get heart palpitations. It all started 9 months ago, and the main treatment has been a month of Omeprazole in the very beginning of the symptoms, a few weeks medication for getting rid of H. pylori and 6 months of Betaloc/Metoprolol. I also experience something like lazy intestines, whereby I often feel like some gas is trapped at a bend of the intestine but instead of there being some readjustment and feeling of relief afterwards, it just remains stuck and under pressure. It all started approx. 9 months ago.

LONG VERSION
It all started in April 2020. I'm gonna relate everything chronologically, some things may be connected to my problem and therefore useful, some things may have nothing to do with the topic. All I can do is try and paint as holistic a picture as possible.
So, I was mildly overweight in January of 2020 and decided to become fitter. I embarked on a regime of caloric restriction, walks and some some exercise (legs and butt exercises; push-ups). About 4 or 4 and a half months later I had lost 20 kg. One evening after the legs and butt exercises I go to take a shower, I felt really hot, and only had lukewarm, or lukecold water. As I was finishing the shower (or maybe the reason why I cut it short) I started getting what felt like a 200 beats per minute heart rate. I was scared and went downstairs to my girlfriend and told her what's up, then sat down. But in the end it passed. This was somewhat of a harsh blow for my psyche because I had had palpitations a few times before in my life, in 2016, when I was going through a very difficult time in my life and everything felt hopeless (not medically, just where my life was going). So the after-shower episode had been the first heart-related problems I'd experienced in 4 years, and it affected me a lot, I guess I am emotionally soft like that.
But anyway, that night I only had that racing heart episode. The next day, however, we went biking around town and I felt these weird heart sensations, these palpitations, like my heart was not working properly. We had our little time in the sun in the park, lying down, and then we started biking towards home, and I started to have these palpitations again only now they felt a bit stronger than before and I got really panicky and basically made a detour on our way home to the ER. We were there for hours waiting and nothing came of it. In hindsight I understand that sitting down in the ER room and not doing any sort of physical activity made the heart palpitations go away. Nothing irregular showed on the EKG and bloodwork that they did on the spot. I went home, the next couple of days my present symptoms started getting into their own, basically when I got out of bed I would get heart palpitations, though I did not make this connection at the time. I went to the ER one more time in those initial couple days following the biking day. I was given Diazepam, Omeprazole also for a month -- some doctors in the ER thought it is an anxiety thing, some doctors asked about things to do with my stomach. It's all one big blur in my head now, so many months and doctors later. I figured I had Roemheld syndrome at some point... Anyway, corona made accessing non-critical medical help very difficult where I live. So I flew to a different country and had investigations carried out there.
I went to a cardiologist. What he noticed was that I was quite 'active', I had an elevated heart rate even when nothing was happening, like lying down on his table. He found a little something on my thyroid. I then went to 3 different endocrinologists at his behest, they all said it's nothing, like yes it shows on the imaging but it is not a trouble causing formation, and it is small.
I went to a stomach doctor and I took a barium imaging test, whereby you drink that awful stuff and then it shows inside you and they can see ulcers or perhaps hiatal hernias or whatever (at some point I was really into the the hiatal hernia hypothesis but apparently that wasn't it, although I do regret I was sent to do an endoscopy, 'too invasive for no good reason yet', the doc said).
As you can imagine I also took a ton of blood tests for minerals and thyroid hormones etc., nothing really stood out, apart maybe from being diagnosed with Helicobacter pylori, for which I had a treatment prescribed that lasted several weeks.
Nothing was found that was wrong with my heart itself, so morphologically. Anyway, after seeing a plethora of doctors in my old homeland I was given 6 months worth of Betalok/Metoprolol, to make my heart rate slower. I have been taking this medication when I wake up everyday for the past half year, and I am now a few days away from completing my treatment. Throughout this whole time whenever I would go up stairs, or engage in physical activity of any kind -- I would get heart palpitations. So the medicine is just mostly masking away the symptoms, but nothing's actually changed.
Along the way, in November 2020 I took a tilt test, they said it looks like vasovagal syncope. They said eat more salt, drink 3L of water and be active every day, which I have been doing, with 0 improvements.
In December 2020, since I could see that my symptoms were very much there and nothing was improving, I took a gut bacteria test and a SIBO test from some guys called Healthpath. SIBO was negative, but gut bacteria test found a number of abnormalities, see link please.
https://imgur.com/a/zd6byEO
What other information can I offer? I'm afraid of dying, something I can't really shake off, so I am considering therapy. And I don't very much like my work but it does pay more than I would otherwise be able to earn doing similar stuff or even the same role but with a less giving company. And I feel like money is pretty important, I couldn't just kick my salary like that, I'm pretty sure I would regret it.
I can't understand what's wrong with me. Oh yeah, the last thing I'm going to say is what I, the patient, think the problem is. I think there is something wrong with my gut, or the vagus nerve, something in or around my abdomen. I feel like my intestinal transit is stuck a lot of times, like there is a great weight in my guts. Or I sometimes get a distinct feeling like I am eating/drinking and I have a very small stomach (I don't, the gastro doctor said I had quite a sizeable one), like things take a long time to exit my stomach, and I feel a very uncomfortable pressure just south of the sternum, like if you press me there where the bone ends and flesh begins, I can feel it very poignantly in my mouth, and inside me.
I beg your forgiveness for the wall of text.
submitted by investorchicken to AskDocs [link] [comments]

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