Heart palpitations are the sensation of a fast-beating, fluttering, or pounding heart, which can feel unsettling, especially when they appear suddenly. Acid reflux, or Gastroesophageal Reflux Disease (GERD), is a common condition where stomach acid flows back into the esophagus, causing a burning sensation in the chest known as heartburn. While these two symptoms seem to originate from entirely separate systems—the cardiovascular and the digestive—many people report experiencing them together. Exploring this relationship reveals a fascinating biological connection.
The Confirmed Link Between Reflux and Palpitations
The answer to whether acid reflux can cause heart palpitations is yes, though the cause is often indirect and related to shared nervous system pathways. This association is sometimes discussed under the umbrella of gastrocardiac syndrome, which describes how digestive issues can trigger heart-related symptoms. The irritation caused by stomach acid backing up into the esophagus can lead to symptoms that feel like a racing or skipped heartbeat. Studies show people with GERD may have a statistically higher chance of experiencing certain heart rhythm disturbances, such as atrial fibrillation.
The symptoms of acid reflux, such as chest tightness or a burning sensation, can often mimic or be confused with true cardiac pain, making the distinction challenging. More than half of emergency room visits for chest pain in the United States are actually cases of severe heartburn. Treating the underlying acid reflux often leads to a reduction or complete cessation of the associated palpitations, strongly suggesting a physiological link between the two.
Vagus Nerve and Esophageal Irritation
The mechanism that links acid reflux to heart palpitations primarily involves the Vagus nerve, the tenth cranial nerve. This long, meandering nerve serves as a communication highway connecting the brainstem to the heart, lungs, and digestive system. It plays a major role in regulating the parasympathetic nervous system, which controls bodily functions when a person is at rest, including heart rate and digestion.
When stomach acid flows back into the esophagus, the lining of the food pipe becomes irritated and inflamed. Because the Vagus nerve runs in close proximity to the esophagus, the irritation or inflammation can stimulate the nerve. This stimulation sends signals back to the brain that can then reflexively affect the heart rate and rhythm. The resulting cardiac symptoms can manifest as a rapid heartbeat, a fluttering sensation, or a feeling that the heart has skipped a beat.
Pressure from a hiatal hernia, a condition where part of the stomach pushes up through the diaphragm, can also contribute to this nerve irritation. A hiatal hernia can both worsen acid reflux and put physical pressure on structures near the heart, including the Vagus nerve. This mechanical and chemical irritation can lead to irregular heart rhythms, especially after large meals.
Other Common Causes of Palpitations
Heart palpitations are a common symptom that can stem from numerous non-reflux causes. A wide range of lifestyle and physical factors contribute to the sensation of a racing or fluttering heart.
Common Non-Reflux Triggers
- Strong emotional responses, such as high stress, anxiety, or panic attacks, which cause the body to release adrenaline.
- Dietary and chemical stimulants, including high intake of caffeine, energy drinks, or nicotine use.
- Certain medications, including some over-the-counter cold and cough medicines containing pseudoephedrine, and some asthma inhalers.
- Hormonal shifts associated with menstruation, pregnancy, or menopause.
- Underlying medical issues like an overactive thyroid, dehydration, low blood sugar, or anemia.
Management Strategies and Urgent Care Guidance
If acid reflux is suspected as the cause of palpitations, treatment focuses on managing the underlying digestive condition. Lifestyle adjustments are often the first line of defense and can significantly reduce the frequency of reflux episodes. Avoiding known trigger foods, such as spicy, fatty, or acidic items, can help limit esophageal irritation. It is also helpful to eat smaller meals and remain upright for at least two to three hours after eating to prevent acid from backing up.
Positional therapy, such as elevating the head of the bed by six to nine inches, can use gravity to keep stomach contents in place during the night. Over-the-counter medications like antacids, H2 blockers, or proton pump inhibitors (PPIs) can reduce stomach acid production and heal the esophageal lining. Successfully treating the reflux with these changes often leads to a corresponding decrease in the frequency of heart palpitations.
It is imperative to know when a heart palpitation requires immediate medical attention, regardless of a history of acid reflux. Palpitations accompanied by chest pain or pressure, severe shortness of breath, dizziness, or fainting should be treated as a medical emergency. These symptoms may indicate a serious cardiac event, and a professional evaluation is necessary to rule out underlying heart disease or a dangerous arrhythmia. Never assume severe symptoms are simply due to indigestion, and seek emergency care immediately if in doubt.