Heartburn and heart palpitations are common sensations that can cause discomfort and concern. While both originate in the chest, they stem from different bodily systems. This article clarifies the nature of heartburn and heart palpitations, explains why they might be confused, and offers guidance on distinguishing between them.
What is Heartburn?
Heartburn is a burning sensation felt in the middle of the chest, often behind the breastbone. This discomfort arises when stomach acid flows backward into the esophagus (acid reflux), which, if frequent, can be diagnosed as gastroesophageal reflux disease (GERD).
Common symptoms include a sour taste in the throat, regurgitation of food or liquid, and discomfort worsening after eating, bending, or lying down.
Certain foods, such as spicy or fatty meals, caffeine, and alcohol, can trigger heartburn by relaxing the lower esophageal sphincter, the muscle preventing acid from escaping the stomach.
What are Heart Palpitations?
Heart palpitations are sensations of an overly aware heartbeat. They can manifest as a racing heart, pounding, fluttering, or skipped beats. While often harmless, these changes can signal an underlying cardiac condition.
Palpitations can be felt in the chest, throat, or neck and may last for seconds or minutes.
Common benign causes include stress, anxiety, panic attacks, strenuous physical exercise, and stimulants like caffeine, nicotine, or certain cold and cough medications. Hormonal changes from menstruation, pregnancy, or menopause can also contribute.
Why Heartburn Can Mimic Palpitations
The confusion between heartburn and heart palpitations arises from their shared anatomical location in the chest. The esophagus, where heartburn occurs, runs directly behind the heart, making it difficult to differentiate the source of discomfort. This proximity can lead to sensations from one organ being perceived as originating from another.
Neural pathways also play a role in this mimicry. The vagus nerve, a major nerve, connects both the digestive system and the heart. Irritation or stimulation of the vagus nerve due to acid reflux or esophageal spasms can send signals that the brain may interpret as cardiac activity, leading to perceived palpitations.
Esophageal spasms, involuntary contractions of the esophageal muscles, can also produce chest tightness or a fluttering sensation similar to an irregular heartbeat.
Furthermore, the discomfort and alarming nature of heartburn can trigger anxiety or stress responses in the body. These emotional states can release hormones like adrenaline, which increase heart rate and induce genuine heart palpitations. This physiological link means heartburn discomfort can indirectly lead to sensations feeling like heart problems.
Differentiating Between Symptoms
Distinguishing between heartburn and heart palpitations involves observing specific characteristics and accompanying symptoms.
Heartburn presents as a burning sensation, often after large or fatty meals, or when lying down or bending over. It may also include a sour taste or regurgitation of stomach contents.
Conversely, heart palpitations are an awareness of the heart’s rhythm, feeling like a fast beat, skipped beat, or fluttering. They can occur at any time and are not linked to food intake or body position like heartburn. Palpitations may be associated with lightheadedness, dizziness, or anxiety.
A practical way to differentiate is to note the response to antacids. Heartburn symptoms often improve or resolve with over-the-counter antacids, which neutralize stomach acid. Heart palpitations, a cardiac sensation, are not affected by antacid medications. Understanding the discomfort’s nature—burning for heartburn versus rhythmic disturbance for palpitations—helps distinguish them.
When to Seek Medical Attention
While many instances of heartburn and heart palpitations are benign, certain symptoms warrant prompt medical evaluation.
Seek immediate medical attention if chest pain, whether burning or pressure-like, is accompanied by shortness of breath, sweating, dizziness, or pain that radiates to the arm, jaw, or back. These symptoms could indicate a serious cardiac event, such as a heart attack.
For heart palpitations, consultation is advised if they are persistent, severe, accompanied by fainting, or occur with other alarming symptoms like shortness of breath or chest discomfort. If you have a known heart condition and experience new or worsening palpitations, consult a healthcare provider.
Heartburn that does not improve with over-the-counter medications, occurs frequently (more than twice a week), or interferes with daily life should be discussed with a doctor, as it might indicate GERD or other issues requiring treatment.