How GERD Can Trigger Heart Palpitations

If you’ve ever felt a flutter in your chest after a heavy meal or late-night snack, it might not be your imagination or your heart acting up on its own. Gastroesophageal reflux disease (GERD), a common digestive condition, can sometimes lead to heart palpitations. While the link isn't always direct, the relationship between your gut and heart is closer than many people realize.

Understanding GERD and Its Symptoms

GERD occurs when stomach acid flows backward into the esophagus, irritating its lining. Common symptoms include:

• A burning sensation in the chest (heartburn)

• Regurgitation of food or sour liquid

• A sensation of a lump in your throat

• Chest discomfort that may mimic heart-related pain

While these symptoms are often manageable with lifestyle changes and medication, their proximity to the heart can sometimes create confusion or unexpected consequences.

What Heart Palpitations Feel Like

Heart palpitations are sensations that your heart is skipping a beat, fluttering, or pounding. They can be brief or ongoing, and although usually harmless, they can feel alarming. These palpitations result from changes in the heart’s electrical rhythm and may not be related to digestion at first glance.

Yet, more than 50% of the 8 million annual emergency room visits in the U.S. for chest pain turn out to be non-cardiac often due to heartburn or acid reflux.

How GERD Might Lead to Heart Palpitations

The esophagus and the heart are close neighbors in the chest cavity, and the vagus nerve connects both organs. This nerve plays a central role in regulating digestion and heart rate. When acid reflux irritates the esophagus, it can also stimulate the vagus nerve, potentially triggering heart palpitations.

There are three primary ways GERD might contribute to irregular heart rhythms:

• Vagus nerve irritation: Acid reflux may overstimulate the vagus nerve, which can influence your heart’s rhythm.

• Hiatal hernia pressure: A hiatal hernia (when the stomach bulges through the diaphragm) can put pressure on heart structures, causing irregular beats.

• Gastrocardiac syndrome (Roemheld syndrome): A lesser-known condition where digestive issues like gas, bloating, or reflux lead to symptoms like palpitations, shortness of breath, and chest pressure.

This gastrocardiac connection, first described in the 1950s, is still being studied, but evidence suggests it may be more common than previously thought.

The GERD and Atrial Fibrillation Connection

Atrial fibrillation (AFib), the most common type of heart arrhythmia, is often marked by palpitations. Emerging research shows a strong link between GERD and AFib. A 2025 review of seven studies found that:

• People with GERD are at increased risk of developing AFib

• Treating GERD early may lower the chances of AFib-related palpitations

• Chronic inflammation and low oxygen levels caused by GERD may contribute to heart rhythm disturbances

Some researchers also believe that ongoing reflux can lead to structural changes in nearby heart tissue, making it more susceptible to arrhythmias.

Other Causes of Palpitations to Consider

While GERD can play a role, other common triggers for heart palpitations include:

• High stress or anxiety

• Stimulants like caffeine or nicotine

• Alcohol consumption

• Certain medications

• Thyroid issues

Interestingly, many of these same factors like alcohol, caffeine, and smoking can also exacerbate GERD, creating a cycle of symptoms that feed into each other.

Getting a Clear Diagnosis

If you're experiencing chest discomfort or palpitations, it’s important not to self-diagnose. Your healthcare provider may recommend several tests to pinpoint the cause:

• Electrocardiogram (ECG): Measures your heart’s electrical activity

• Holter monitor: A portable ECG that records your heart rhythm over 24–48 hours

• Cardiac stress test: Monitors how your heart performs under exertion

• Echocardiogram: Ultrasound imaging to examine heart function

• Transesophageal electrophysiologic study: A highly sensitive test that uses a tube passed through the esophagus to record heart rhythms

For suspected GERD, your doctor might also order:

• Endoscopy: To look at the lining of the esophagus and stomach

• 24-hour acid monitoring: To track acid reflux episodes

• Barium swallow: An imaging test to assess esophageal movement and structure

Treatment Options for GERD

Addressing GERD may help reduce palpitations, especially if they’re linked to digestive flare-ups. Common GERD treatments include:

1. Lifestyle changes:

   • Avoid trigger foods (e.g., citrus, chocolate, caffeine, alcohol)

   • Eat smaller meals

   • Avoid lying down after eating

   • Elevate the head of your bed

   • Lose weight, if needed

   • Quit smoking

2. Medications:

   • Antacids (for quick relief)

   • H2 blockers (reduce acid production)

   • Proton pump inhibitors (PPIs) (stronger acid reducers)

If GERD symptoms persist or a hiatal hernia is involved, surgical options like fundoplication may be considered.

When to Talk to Your Doctor

Any new or unexplained chest symptoms especially those involving irregular heartbeats should be evaluated promptly. Even if GERD is the culprit, it's essential to rule out potentially serious heart conditions.

The Takeaway

GERD can do more than just cause heartburn it can, in some cases, indirectly influence your heart rhythm. Whether through vagus nerve stimulation, pressure from a hiatal hernia, or inflammation, the relationship between digestion and heart health is complex but real. Understanding this connection can help you better manage both conditions and know when to seek care.

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