What causes a flutter sensation in the left chest when sneezing?

From the Guidelines

The flutter sensation in the left chest when sneezing is most likely caused by gastroesophageal reflux disease (GERD) or other gastrointestinal issues, which can be triggered by the sudden increase in intrathoracic pressure during a sneeze. According to the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain, gastrointestinal causes are responsible for approximately 10% to 20% of chest pain cases in outpatients 1. Gastrointestinal pain may result from stimulation of chemoreceptors by acid or hyperosmolar substances, of mechanoreceptors by abnormal contraction or distention, or of thermoreceptors.

Some key points to consider:

• Gastroesophageal reflux disease is the most likely cause for recurring unexplained chest pain of esophageal origin 1
• Chest pain caused by gastroesophageal reflux disease can mimic myocardial ischemia and may be described as squeezing or burning
• The duration of chest pain caused by GERD can be minutes to hours, often occurs after meals or at night, and can worsen with stress
• Depending on the severity, it may or may not resolve spontaneously or with antacids

It is essential to consult a healthcare provider if you experience chest pain, severe palpitations, shortness of breath, dizziness, or if the sensation persists after sneezing, as these symptoms could indicate an underlying cardiovascular issue that requires medical attention.

From the Research

Possible Causes of Flutter Sensation in the Left Chest when Sneezing

• The exact cause of a flutter sensation in the left chest when sneezing is not directly addressed in the provided studies. However, some studies suggest that arrhythmias, such as atrial flutter, can cause symptoms like palpitations or a fluttering sensation in the chest 2, 3, 4.
• Gastroesophageal reflux disease (GERD) is also mentioned as a potential cause of non-coronarogenic pain in the thoracic cage, which could be related to a flutter sensation in the left chest when sneezing 2.
• Other studies discuss the importance of considering various differential diagnoses when evaluating chest pain, including life-threatening conditions like acute coronary syndrome and non-threatening causes like costochondritis or gastric reflux 5.
• The relationship between sneezing and arrhythmias or other cardiac conditions is not explicitly discussed in the provided studies. However, it is possible that the physical act of sneezing could trigger or exacerbate underlying cardiac conditions, leading to a flutter sensation in the left chest 6, 3, 4.

Relevant Cardiac Conditions

• Atrial flutter is a common atrial arrhythmia that can cause significant symptoms and serious adverse effects, including embolic stroke, myocardial ischemia and infarction, and tachycardia-induced cardiomyopathy 3, 4.
• Ventricular arrhythmias, such as ventricular tachycardia, can also cause symptoms like palpitations or a fluttering sensation in the chest 6.
• The provided studies suggest that catheter ablation is a safe and effective treatment for typical atrial flutter, and that medical management of this condition is often challenging due to poor efficacy of rate-controlling and antiarrhythmic drugs 3, 4.