Why this story is interesting
This story was submitted by Charles Ashcroft, co-founder and editor of Roemheld.org.
Unlike many patient accounts, it describes a journey that includes a confirmed myocardial infarction, extensive cardiac and gastrointestinal investigations, repeated ECG recordings, Holter monitoring, echocardiography, gastroscopy, and participation in a supervised cardiac rehabilitation program. Over time, the author carefully documented his symptoms and repeatedly observed a striking relationship between meals and premature ventricular contractions (PVCs).
What makes this account particularly noteworthy is the combination of objective findings and personal observation. The author reports that his PVCs frequently began approximately 30 minutes after eating, often improved with antacids and proton pump inhibitors, and could sometimes be relieved by a short walk after meals. While these observations cannot establish a causal relationship, they closely resemble symptom patterns described by many other patients with suspected gastro-cardiac syndrome.
This story also illustrates another important aspect of living with frequent PVCs: even when cardiac investigations are reassuring, recurrent symptoms can have a profound impact on quality of life, physical activity, and mental well-being.
Patient Profile
Current Status: Participating in a supervised cardiac rehabilitation program while continuing to investigate possible gastro-cardiac mechanisms
Name: Charles Ashcroft
Age: 53 years
Country: The Netherlands
Primary Symptoms: Frequent PVCs, post-meal palpitations, anxiety during attacks
Medical History: Myocardial infarction (2024), coronary stent placement
Cardiac Evaluation: Multiple ECGs, Holter monitoring (~2,500 PVCs/day), normal echocardiogram
Gastrointestinal Findings: Gastroscopy showed lower esophageal sphincter dysfunction
Symptoms Associated With: Meals, gastric symptoms, physical inactivity
Treatments That Provided Relief: Antacids, Pantoprazole, beta-blockers, light walking after meals
Hello,
My name is Charles, I am 53 years old, and I live in Amsterdam, the Netherlands. I believe I suffer from Roemheld Syndrome. Actually, I am convinced of it.
First, some background.
I have always been a “nervous” type. When I was 21, I was suddenly hit by a panic attack. I no longer remember exactly why or how it happened, but I do remember how it ended: numerous examinations of my heart, lungs, and brain. Psychologists, physiotherapy, occupational therapy, and so on.
To be fair, the healthcare system in the Netherlands was good then and still is today. People often joke that we get sent home with a paracetamol for everything, but when something is genuinely wrong, you can count on receiving good care.
After a period of agoraphobia and feeling miserable, I was diagnosed with chronic hyperventilation and generalized anxiety disorder. Eventually, I started taking diazepam and paroxetine. With ups and downs, I have lived a good life and have overcome severe anxiety. I’ve seen the world, lived abroad, I’m a public speaker, I like my job, I love to laugh, I’m a skeptic and a cynic, but I’m still able to cry when I see the movie Marley and Me, even though I don’t have a dog. I do have a daughter though, even better company!
Since this is not a biography, let’s fast-forward thirty years.
One evening in November 2024, I developed chest pain that would not go away, not even after taking several antacid tablets (yes, I thought it was acid reflux). Long story short: the next day I went to my doctor, who immediately sent me to the hospital by ambulance. It turned out I had suffered a heart attack. A stent was placed, and a few days later I was allowed to go home.
Whenever people told me how serious it was, I would reply, “Come on, a root canal treatment is much worse.” And honestly, that is how I felt. After the stent was placed, I actually felt fitter than before. Not fit—far from it, but fitter. I had been living a very inactive lifestyle, spending entire days behind a computer screen with hardly any exercise. But the stent did make me feel somewhat better.
Until March 2025.
That was when the palpitations started.
At first, I assumed it was a one-time thing. Then they returned a few days later, again after a meal. Soon they were happening every day, always after eating.
No, I am non a hypochondriac. Normally, I blame physical complaints on my personality (“I’m the nervous type”) and stress. But this felt different. To me, the connection with food was obvious. One day, the PVCs felt so bad, I called an ambulance. They came, monitored me, saw massive PVCs, and reassured me I wasn’t dying.
Because I was afraid of the palpitations, I started eating less. Whenever I did eat, I would take an acid-suppressing medication afterwards, and I noticed it provided some relief. The result was that I lost seven kilograms in a single month.
I told my general practitioner about this, and he suggested I try a medication called Antagel. I had no idea what it was (it was a different type of antacid), but I took the gel, and a miracle happened: the skipped beats stopped.
I felt enormously relieved and started eating normally again. No problems at all.
The result? Seven kilograms gained back.
In October, the skipped beats returned, again after meals. By this point, I had started reading about the subject and learned that what I was experiencing were actually PVCs. I also discovered that my smartwatch could record ECG tracings. Since then, I have probably recorded more than 500 ECGs, all in an effort to prove that the PVCs were real. A bit obsessive, I know.
Off to the cardiologist.
His response was: “Hmm… yes, it could be.”
He advised me to take an extra Pantoprazole before meals, and if that did not help, to try half an extra beta-blocker tablet. (Anyone who has suffered a heart attack goes home with a handful of medications, some of which are intended for lifelong use.)
He also ordered a Holter monitor and an echocardiogram. And I was sent to a gastroenterologist, for a gastroscopy.
Waiting time: 30 days.
Then another miracle happened.
The Pantoprazole worked immediately.
Again, I felt relieved.
Good news, because I had no interest in taking more beta-blockers.
Thirty days later, I underwent the Holter monitoring and echocardiogram. At the time, I felt completely fine and remember thinking:
“I bet they’re barely going to record any PVCs.”
A week later, I received the results.
It turned out I was having around 2,500 PVCs per day. The echocardiogram was fine.
Interesting, but not particularly alarming, as I already knew that PVCs in general are not dangerous. And of course, I wasn’t experiencing any symptoms anymore. Why worry? The gastroscopy showed some sphincter dysfunction. The gastroscopy was not very nice, but the gastroenterologist was a nice man, who told me that Gastro-Cardiac Syndrome could indeed be the case. He agreed I should take an extra Pantoprazole before diner, and explained PPIs are not as harmful as others might suggest.
Let’s fast-forward several more months.
The PVCs came back with a vengeance.
I started measuring them during attacks, which usually began about 30 minutes after eating and varied in duration. Sometimes they lasted an hour, sometimes four hours.
I also started noticing PVCs that didn’t appear to be related to food at all. They would occur when waking up, for example, or after physical exertion.
On average, I was experiencing 10 to 15 PVCs every 30 seconds during attacks.
The anxiety returned. Again, one day it got to the point where I simply had to call an ambulance. Pretty much the same story. Monitored, discussed options and decided not to take me to the hospital. If it happened again within 48 hours, they would take me in. It didn’t happen again, at least not that bad. I realised the fear wouldn’t simply vanish.
I also realised that my physical condition was poor. I was exhausted, easily fatigued, and had developed a fear of exercise.
Something had to change.
I went back to my GP and asked whether it was still possible to participate in a cardiac rehabilitation program. Stubborn as I was, I had declined that offer after my heart attack.
Fortunately, it was still possible, and a few weeks later I was accepted into the program.
The waiting period, however, became difficult. After consulting yet another cardiologist (I think my third or fourth by then—doctors rarely stay in the same place for long here), I decided to increase my beta-blocker dose.
And yes, it helped.
But in a different way.
The PVCs remained—I kept measuring them—but they became muted.
It felt as if I had put on a pair of headphones, without music, in a noisy environment.
I did experience side effects such as dizziness, lightheadedness, and balance problems, so I slightly reduced the dose until I found a balance between effectiveness and side effects.
Again, I felt relieved.
But the cardiac rehabilitation program had not even started yet, and I was looking forward to it. I felt that my lack of fitness might be one of the underlying causes of my problems.
The rehabilitation program lasts at least three months and involves an interdisciplinary team consisting of a physician, physiotherapists, social workers, psychologists (focusing on body awareness, education, and relaxation exercises), and a dietitian.
The intake assessment included an exercise stress test.
The results were, well… not great.
Let’s just say that my own belief that I was “not in very good shape” turned out to be a considerable understatement.
The test showed that my physical condition was absolutely terrible.
I, a young god of 53, apparently had the biological age of someone between 75 and 80 years old with health issues.
Fast-forward again to the present day.
The body-awareness program has been completed, and I have now been participating in the physiotherapy component for about a month.
This mainly consists of endurance training (cycling, walking, swimming) and strength exercises. We train in a small group under the supervision of three fantastic physiotherapists who guide us continuously. Our heart rates are monitored throughout the sessions, and they provide excellent advice: don’t do too much, but don’t do too little either.
Do I notice that my fitness is improving?
Yes.
But I want to wait until the end of the program before making a final judgment.
(I have also joined a gym so that I can maintain my improved fitness once the rehabilitation program ends. Me, in a gym. People that know me can’t believe it, trust me. But hey, it’s for a good cause: me).
I often feel like the least serious patient in the rehabilition-group.
I train alongside people ranging from 17 to 70 years old, and many of their stories are deeply moving. People with congenital heart defects, artificial heart valves, open-heart surgery, and even one person who underwent a heart transplant only three months ago – and who is in far better shape than I ever was.
And then there is me, showing up with my Roemheld Syndrome.
No. That is not the right way to think.
I should not compare myself to others.
What matters is your own condition and how you experience it.
There will always be someone who is worse off.
In the end, it is about quality of life.
Finally, I also understand very well that what works for one patient does not necessarily work for another. Every human being is different, and the body is incredibly complex.
For me, the following treatments helped:
- Antacids
- PPIs (Pantoprazole in my case)
- Beta-blockers
- Whenever a PVC attack started, I would sit or lie frozen on the couch, frightened and waiting for it (or me) to end. Over time, when researching the topic, I came across ideas suggesting that a short walk after eating—even just five minutes indoors—could help. Not laying down right after meals wasn’t very good too. To my surprise, it often did help. The palpitations would ease, and it almost felt as if my heart had been “reset. Of course, after that, I was too tired, I had to lie down.
I am curious to see what effect my lifestyle changes will have. It felt like my body actually started screaming: “I need to exercise, damned”. I simply realised I was completely inactive, up to the point I had my groceries delivered to my home, since the walk to the supermarket (200 metres) was too long. Did I mention I also have a lazy disposition?
What I do know is this:
It is NOT all in my head.
The connection between eating and PVCs is so clear and measurable that I am 100% convinced the problem, and hopefully the solution, is to be found somewhere in that connection. I’m willing to try anything.
Good luck all!
Charles
Editor’s Note
As both the founder of Roemheld.org and the author of this story, I believe it is important to distinguish my personal experience from scientific evidence.
I cannot prove that my symptoms are caused by Roemheld Syndrome, nor do I suggest that the same mechanisms apply to everyone experiencing PVCs or other cardiac symptoms. However, after extensive cardiac and gastrointestinal evaluation, years of symptom tracking, and hundreds of ECG recordings, I have become convinced that there is a reproducible relationship between my gastrointestinal system and cardiac symptoms.
Ultimately, this personal journey is the reason Roemheld.org was created: not to promote a particular theory, but to provide an evidence-based resource where patients, physicians, and researchers can explore the existing scientific literature, historical publications, expert perspectives, and patient experiences surrounding the possible relationship between gastrointestinal disorders and cardiac symptoms.
I hope that sharing my story encourages others to seek appropriate medical evaluation, remain open-minded, and contribute to a better scientific understanding of this fascinating and often overlooked area of medicine.