By
Jo Waters
17:28 EST, 22 July 2013
|
17:37 EST, 22 July 2013
David Price returned from his holiday in Malaysia feeling extremely unwell.
‘I kept having attacks where my heart was racing very fast and pounding in my chest,’ says retired economist David, 78, who lives in Wilmslow, Cheshire, with his wife, Vera, 80, a retired academic.
‘It usually happened an hour or so after meals – but the attacks would eventually pass so I didn’t seek medical advice while we were away.’
Food attacks: David Price, 78, noticed that certain foods and drinks triggered his heart palpitations
David was very fit, in good health and rarely visited his GP. Although the attacks continued when he returned home he was still reluctant to see a doctor. But after four weeks Vera persuaded him to go. The GP suspected it was ‘a bug he’d picked up overseas’ and sent him away with antibiotics.
‘The doctor didn’t even listen to my heart but I assumed he knew best and gave the tablets a try,’ recalls David.
But the palpitations continued, so David returned a week later and saw another doctor who did listen to his heart – and then told Vera to drive David straight to hospital.
‘My heart was racing at over 200 beats per minute – normal resting heartbeat is around 60 to 80 and my blood pressure was sky high,’ recalls David.
David was suffering from atrial fibrillation, an abnormal heart rhythm caused when the upper chambers of the heart, the atria, beat irregularly.
The condition is the most common form of heart rhythm problem (or arrhythmia), and it affects at least a million people in the UK. It can be linked to heart failure (where the heart doesn’t pump blood properly) although it’s not clear whether atrial fibrillation causes heart failure, or vice versa.
The main danger with atrial fibrillation is stroke – it increases the risk five-fold, as the irregular heart rhythm causes blood to pool, allowing blood clots to form then travel to the brain.
After being diagnosed with heart failure David was prescribed various drug treatments, but none helped with the racing heartbeat. ‘I saw three different cardiologists at two different NHS hospitals, but all they did was try me on different drugs – none of which worked.
Sacrifice: Red wine, cheese and anchovies are amongst the items that were sending David into atrial fibrillation attacks – he’s had to give them up
‘I continued to suffer two or three attacks a week, each lasting between one and two hours. It was all very worrying.’
Then a pharmacist mentioned that food can sometimes trigger attacks, and David carried out research on the internet. He found the case of a 60-year-old man whose arrhythmia was triggered by cheese, tinned food, broad beans, and Chianti wine reported in the British Heart Journal.
After being advised to avoid foods containing tyramine and phenethylamine – natural chemicals which have a stimulating effect on the heart – the man’s attacks stopped.
Tyramine is found in its highest concentrations in cheese, cured meats and pickled fish (basically any foods that have been pickled, fermented, aged, smoked or marinated – this includes alcohol); phenethylamine is found only in chocolate.
All this struck a chord with David. ‘I’d begun to notice that certain foods and drinks could trigger attacks an hour or so later, particularly if consumed together.’ He remembered the attacks in Malaysia happened after enjoying exotic foods and red wine.
‘I’d also noticed that if I ate an Italian meal with lots of cheese and anchovies and drank red wine it would nearly always trigger an attack. Unfortunately tyramine was in a lot of my favourite foods such as strong, mature cheeses, overripe fruit, vegetables, stock, and yeast extract.’
One of the most concentrated sources of tyramine is the durian fruit – the delicacy David first ate on his holiday in Malaysia.
David decided to cut out all foods containing tyramine (while continuing to take his medication), and the attacks stopped – apart from when he dined out.
‘It was difficult to eat out, as I could never be sure there wasn’t tyramine in ingredients such as stock cubes. On those occasions I would nearly always have an attack,’ he says.
But tyramine and phenethylamine aren’t the only triggers.
Caffeine is a suspect in heart rhythm problems – and that means cola drinks can be a trigger, the European Society of Cardiology Congress heard in June.
Â
‘David decided to cut out all foods
containing tyramine (while continuing to take his medication), and the
attacks stopped – apart from when he dined out.’
In one case at the Princess Grace Hospital in Monaco, a patient who’d drunk cola instead of water for years developed arrhythmia, possibly because it affected potassium levels in the patient’s body.
In another, the culprit was not cola, but a particular type of Black Sea Turkish honey. A father and son suffered palpitations, dizziness, nausea and vomiting after eating honey contaminated with grayanotoxin, a chemical in nectar from a type of rhododendron.
Lead researcher Dr Uger Turk of Central Hospital, Izmir, Turkey, said the possibility of rhododendron honey poisoning ‘should always be considered in previously healthy patients admitted with unexplained heart rhythm problems’.
Professor Andreas Goette, chairman of the Congress’s scientific programme committee, says: ‘Both studies underline the importance of clinicians taking detailed medical histories for patients with arrhythmias and including questions about their dietary intakes,’
The role of food and drink, and even gastric illness, in triggering arrhythmias is too easily overlooked, says Dr Adam Fitzpatrick, a consultant cardiologist at Manchester Royal Infirmary.
‘If they’re lucky, patients with arrhythmias may be told not to drink too much coffee or cola by their cardiologists – but food is seldom mentioned.
‘Yet certain chemicals, such as tyramine, in food and drink can act like adrenaline on the heart and over-stimulate it, causing an irregular heartbeat, and elevated blood pressure,’ adds Dr Fitzpatrick, who is also medical director of the Arrhythmia Alliance charity.
‘Any stimulant, including caffeine in coffee and cola, tyramine in food – or lowered levels of potassium or magnesium (caused by vomiting and diarrhoea through gastric illness) – can irritate the heart, increasing the risk of an arrhythmia.’
Ripe old age: Certain fruits past their peak, including bananas, contain too much tyramine, a natural chemical that has a stimulating effect on the heart
This includes atrial fibrillation in some individuals, putting them at risk of stroke, heart failure and dementia, the latter through poor blood supply to the brain.
‘Often it’s not food and drink alone but a combination of food and drink with other factors. For instance, the patient may drink too much cola and be on certain beta-blockers which can sometimes also cause heart arrhythmias,’ he says.
Dr Fitzpatrick says although the Monaco report was based on just one patient, it was significant, and people should be aware that drinking large amounts of cola could cause low potassium levels, which irritates the heart.
Dr Duncan Dymond, consultant cardiologist at London’s Wellington Hospital, also believes people should be warned about the links between food and arrhythmias, even if at the moment the link is based just on anecdotal reports.
‘Patients often tell you what’s wrong – they know they get attacks after eating a big lump of cheese, for instance. There may be no randomised trials in learned journals, but it’s certainly well known in clinical practice that certain foods can trigger attacks.’
However, Dr Tim Betts, consultant cardiologist at the John Radcliffe Hospital, Oxford, says that apart from alcohol binges, there’s not much evidence that food and drink make a difference.
‘Patients with palpitations who notice attacks linked with certain foods could try avoiding the food and seeing what happens, though. It might work for them – but we can’t tell everyone with atrial fibrillation to stop eating cheese as the evidence just isn’t there.’
David Price followed a strict no-tyramine diet for ten years but three years ago consulted Dr Fitzpatrick after finding it too restrictive. He now takes another drug which gives him more variety in his diet, but still avoids eating tyramine–rich foods at the same time.
He adds: â€There’s no doubt in my mind foods trigger my attacks. I want to let other atrial fibrillation patients know about it.’
Arrhythmia Alliance, heartrhythmcharity.org.uk; AF Association, atrialfibrillation.org.uk
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I heard over ripe bananas (when they start getting speckles on the skin) contain anti cancer in em
themajoritynottheminority
,
Manchester,
23/7/2013 23:57
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I get fobbed off all the time. I’ve been trying to tell the doctors for years that certain foods set my arythmia. They just snub me and look at me funny. I cant drink alcohol for this very reason. Nor can I eat cheese. Salty foods often set it off too. Doctors never seem to want to hear it from those who ACTUALLY suffer with it. They would rather bury their small minds in what the books say, because we know nothing after all. It’s so frustrating and upsetting. Not to mention â€unfair†because while they’re being indifferent, we are suffering and our lives are going to waste. 2-3 attacks per week? I know people (including myself) who suffer(ed) like this all day, day in day out. It’s debilitating but because we aren’t at immediate threat of death we do not matter…….. I’ve actually had gp’s say to me: â€you could be worse off you know†or â€don’t worry you won’t die.†It’s disgusting how they play god like that. Disgusting….
Louise
,
Cambridge, United Kingdom,
23/7/2013 21:32
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I have suspected this for some time. I get sporadic AF attacks where my heart goes back to normal rhythm afterwards. I have noticed that after eating certain foods I would get palpitations and then an upset stomach causing a need to rush to the loo. I really believe that gastric problems can lead to heart palpitation as can trapped air which has to bypass the heart as it pushes its way up and out as burping. My cardioligists have told me that patients with sporadic AF who do not have a diseased heart or high blood pressure are not at risk of taking a stroke or heart attack as those who have constant AF or high blood pressure. My old nan had a saying “doctors differ and patients dieâ€.
AMPS
,
Birmingham,
23/7/2013 15:24
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Very interesting, useful article. So much more helpful than the usual scare stories. My mother suffers from atrial fibrillation so it might be worth her cutting out a few of these trigger foods.
Bluebell
,
Somewhere south, United Kingdom,
23/7/2013 11:11
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Good for this man to do some of his own research after being fobbed off by Doctors..What a world of differecnce it has made to him relying on his own instincts after trying ‘conventional’ ways and advice.
Calumet
,
London, United Kingdom,
23/7/2013 08:20
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