How GERD Can Trigger Heart Palpitations

If you've ever felt a fluttering heartbeat after a heavy meal, you might have brushed it off as anxiety or caffeine. But for some people, there may be a more complex link at play. Gastroesophageal reflux disease (GERD) a condition where stomach acid flows back into the esophagus can, in certain cases, lead to heart palpitations.

While GERD and irregular heartbeats aren’t typically grouped together, research is revealing multiple ways in which digestive issues might trigger cardiovascular symptoms. Here's what you need to know about how these two systems can influence each other and when to seek medical attention.

GERD and Its Overlapping Symptoms with the Heart

GERD is known for causing:

• Burning chest pain (heartburn)

• Throat tightness

• The sensation of food or liquid coming back up

These symptoms often mimic cardiac issues, which explains why over half of the 8 million annual ER visits for chest pain in the U.S. are ultimately diagnosed as heartburn not heart attacks.

On the other hand, heart palpitations are a symptom of abnormal heart rhythms and may feel like:

• A flutter or skipped beat

• Rapid or pounding heartbeat

• A racing heart, even at rest

So how does a digestive disorder end up affecting your heartbeat?

1. The Vagus Nerve Connection

The vagus nerve plays a major role in regulating digestion and heart rate. When GERD irritates this nerve due to acid reflux or pressure in the esophagus—it can cause:

• Disrupted heart rhythms

• Skipped or irregular heartbeats

• A sensation of tightness or fluttering in the chest

This nerve runs from the brainstem through the chest and abdomen, acting as a vital communication highway between the gut and heart.

2. Gastrocardiac Syndrome (Roemheld Syndrome)

Gastrocardiac syndrome refers to heart-related symptoms caused by digestive issues, and it’s more common than many people realize. The exact mechanism isn't fully understood, but several factors are involved:

• Hiatal hernia pressure on the heart, especially the left atrium

• Reflex signals between the gut and heart causing arrhythmias

• Gas and bloating affecting diaphragm position and chest pressure

This condition can cause palpitations, chest discomfort, shortness of breath, and anxiety symptoms that often overlap with cardiac disorders.

3. GERD and Atrial Fibrillation (AFib)

A growing body of research suggests a link between GERD and atrial fibrillation (AFib), a common heart arrhythmia. A 2025 review of seven studies found that:

• People with GERD have a higher risk of developing AFib

• Early treatment of GERD may reduce that risk

• Chronic inflammation and hypoxia from GERD may contribute to irregular heart rhythms

• Vagal nerve irritation may also play a role in triggering AFib

While more research is needed, this connection emphasizes the importance of managing GERD especially for those with other risk factors for heart disease.

When Palpitations Are Not Caused by GERD

Heart palpitations may also be triggered by:

• Stress or anxiety

• Caffeine or alcohol

• Tobacco use

• Certain medications

• Underlying heart conditions

Since some of these risk factors also worsen GERD, the two conditions may appear together even if they aren't directly linked.

Diagnosing the Root Cause

To determine whether GERD is causing your palpitations or if something more serious is at play your healthcare provider may recommend:

Heart-focused tests:

• Electrocardiogram (EKG/ECG)

• Holter monitor (24–48 hour rhythm recording)

• Cardiac event recorder (longer-term monitoring)

• Echocardiogram (ultrasound imaging)

• Transesophageal electrophysiologic test, which uses a probe in the esophagus for a highly accurate heart rhythm assessment

Digestive-focused tests:

• Upper endoscopy to evaluate esophagus inflammation or damage

• Barium swallow to examine esophageal movement

• Ambulatory acid monitor, similar to a Holter monitor but for tracking acid reflux over 24 hours

Getting a comprehensive diagnosis is key to treating the right condition effectively—and avoiding unnecessary medication or procedures.

Managing GERD to Reduce Palpitations

Treating GERD may help alleviate related heart symptoms, especially if gastrocardiac syndrome or vagal nerve irritation is at play. Common treatments include:

Lifestyle changes:

• Avoiding trigger foods (citrus, caffeine, alcohol, spicy or fatty foods)

• Eating smaller meals

• Not lying down after eating

• Elevating the head of your bed

• Quitting smoking

• Losing weight if needed

Medications:

• Antacids for quick symptom relief

• H2 blockers to reduce acid production

• Proton pump inhibitors (PPIs) for more severe or chronic GERD

Always discuss any medication changes with your doctor, especially if you’re already taking drugs for heart conditions or blood pressure.

The Bottom Line

GERD doesn’t directly cause heart palpitations, but its close anatomical relationship to the heart and its effects on the vagus nerve may trigger symptoms in some people. Conditions like gastrocardiac syndrome or AFib have demonstrated links to GERD, and early management may reduce these complications.

If you’re experiencing new heart palpitations, especially alongside GERD symptoms, consult your healthcare provider for a full evaluation. Treating the digestive issue may be part of the solution but never assume heart symptoms are harmless without proper testing.

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