A bodybuilder was hospitalized more than a dozen times with a mysterious heart condition caused by drinking water.
It took Franklin Aribeana, 35, and doctors years and 25 hospital visits to trace the source of the problem: drinking ice water after exercising.
They theorized that when the ice water hit the back of his throat, it irritated the vagus nerve that connects the brain to the heart.
Because his heart rate had already increased due to exercise, they suggested that this caused the organ to beat erratically, in a condition medically called atrial fibrillation.
The Houston, Texas, native already has irregular heartbeats and an enlarged part of his heart, which can make erratic heartbeats more likely because his heart is already under greater stress.
Franklin Aribeana, 35, from Texas, would collapse after drinking ice water (pictured above exercising)
Aribeana, pictured above, is also a bodybuilder. At first, doctors didn’t know what was causing the heart problems.
He suffered from the reactions for more than a decade and a half before suspecting that cold water might be the trigger (pictured above in the hospital after an episode with his heart).
Aribeana described the situation to local media: “While I drink the water, [I feel] Probably the most noticeable hit to my chest… I’ve never experienced it before.
“I’m taking a drink of cold water and as I’m settling in, I feel the double whammy.”
Describing another incident when he collapsed on a golf course, he said: “I took a sip of cold water and the next thing I knew I was literally having palpitations coming out of my chest.”
“They took my shirt off and you could literally see my heart beating out of my chest, and then I passed out.”
To treat his condition, doctors cauterized the connection between his vagus nerve and his heart, or cut the connection.
Cold water can activate the vagus nerve because it can activate a response known as the “dip reflex.”
This is usually triggered by exposure to cold water, but in rare cases it can also be triggered by cold water in the throat.
The reflex triggers the slowing of the heart rate to help conserve oxygen, as well as the tightening of blood vessels in the extremities, such as the hands and feet, to redirect blood to vital organs.
Typically, these changes are short-lived and resolve as soon as someone is no longer exposed to cold water.
But in people with underlying medical conditions, such as an enlarged heart chamber, the reflex can cause a sudden drop in blood pressure, leading to collapse. It can also cause the heart to start beating erratically.
Aribeana said he has not had any complications since the procedure and can now drink cold water without any problems.
However, he still takes heart medication due to his genetic condition.
Aribeana said he first collapsed in 2007, at the age of 18, after drinking cold water while on a golf course on a hot summer day.
He has also since reported that he collapsed while at the gym, again after drinking cold water.
Dr. Khashayar Mematpour, a heart disease expert at Texas Medical Center, said Aribeana’s condition was rare.
He also diagnosed her genetic heart disease, caused by mutations in the RBM20 gene, which caused the left chamber of her heart to enlarge.
This makes atrial fibrillation (or disruption of electrical signals that causes the heart to beat erratically) more likely because the heart is already under greater pressure and may contain more scar tissue that disrupts electrical signals.
This condition is not common and is estimated to be suffered by fewer than one in 2,500 people in the US.
Dr Mematpour said: ‘Franklin is a phenomenal individual! He has a lot of drive! He was very aware of his treatment.’
Tests showed it was caused by cold water stimulating the vagus nerve in the throat, causing the heart to start beating erratically.
Mr. Aribeana has had his vagus nerve cauterized and can drink cold water without suffering a reaction (pictured).
He added that Mr Aribeana’s trigger was rare and usually caused “subtle symptoms” such as “feeling a little more tired than usual, shortness of breath or chest pain”.
The vagus nerve is one of the 12 cranial nerves in the body and runs from the brain stem to the abdomen, through the throat.
It is part of the autonomic nervous system (ANS), or the part of the nervous system that controls involuntary functions such as heart rate or breathing.
This nerve can be stimulated by objects in the throat, such as cold water, which can cause it to send erratic signals to the heart, causing atrial fibrillation.
Nerve complications may be due to a previous injury to the neck or compression of the nerve by surrounding tissue, such as enlarged blood vessels.
They may also be related to genetic conditions that affect the heart.
Problems with the vagus nerve can be diagnosed with a breathing test, which shows how much your heart rate changes in response to changes in the rhythm of breathing.
