Dear Dr. Zipes: In a prior response, you explained that caffeine, alcohol, energy drinks, and sometimes swallowing, coughing, or an upset stomach may cause irregular heart rhythms. Can you provide a list or direct me to a web site listing other foods that may cause an irregular heart beat? Might sneezing also trigger the problem?
Dear Reader: The short list I gave includes the most common food offenders. Sometimes food can trigger arrhythmias indirectly. For example, if you ate something that caused severe diarrhea and vomiting, you could develop electrolyte abnormalities, such as low potassium or low magnesium that can cause irregular heart beats, particularly in individuals with underlying heart or pulmonary diseases, or who are taking heart medications. There are also a host of drugs that can cause irregular heart rhythms, depending on an individual person’s sensitivity, including diuretics, heart medications like digitalis or antiarrhythmic drugs taken to prevent arrhythmias, and—in susceptible individuals—even the relatively harmless antibiotic erythromycin. Ephedra (now banned in the United States and some other countries) or similar drugs in energy drinks can precipitate arrhythmias, some of which can be life threatening. Illegal street drugs like cocaine or amphetamines can cause arrhythmias and even sudden death. A Web site for drugs to avoid for individuals with an ECG abnormality called long QT syndrome can be found at arizonacert.org. In general, people with a normal heart who eat a normal diet and eat and drink approved substances in moderation have nothing to worry about. Sneezing could cause an arrhythmia. If you are interested in learning more about arrhythmias, watch the second segment of David Grubin’s Emmy award-winning PBS documentary, The Mysterious Human Heart, during which we talk about heart rhythm problems.