The unsettling feeling of a racing or fluttering heart, known as heart palpitations, often occurs alongside the burning sensation of heartburn. Heartburn is the common term for acid reflux, a condition where stomach acid flows backward into the esophagus, causing a painful, burning feeling in the chest. Palpitations are the awareness of your heart beating, which may feel like it is pounding, skipping a beat, or racing faster than usual. Although the heart and the digestive system are distinct organs, their close physical proximity and shared neurological pathways mean that irritation in one area can affect the other.
The Vagal Nerve Connection
The connection between digestive distress and heart rhythm is primarily mediated by the vagus nerve, which is the tenth cranial nerve and a significant component of the body’s autonomic nervous system. This extensive nerve travels from the brainstem down to connect to many organs, including the heart, lungs, and the entire digestive tract. When the esophagus becomes irritated or inflamed by stomach acid during an episode of reflux, it can stimulate the vagus nerve.
This stimulation can trigger what is sometimes referred to as the esophago-cardiac reflex or gastrocardiac syndrome. The nerve signals mistakenly sent to the heart can disrupt its normal rhythm, causing a temporary acceleration or irregularity perceived as palpitations. Because the esophagus and heart are physically close, the irritation from acid reflux can be interpreted by the nervous system as a cardiac event due to the overlapping sensory nerves in the chest. The resulting palpitations are typically a benign, temporary reaction to the digestive irritation.
Shared Triggers and Exacerbating Factors
Beyond the direct nerve pathway, the symptoms of heartburn and a racing heart often occur together because they are frequently set off by the same external factors. Stress and anxiety are powerful shared triggers, as they activate the body’s “fight or flight” response, which naturally increases heart rate while also potentially altering digestive function. This heightened state can make one more sensitive to both acid reflux and heart rhythm changes simultaneously.
Dietary choices are another common link, as certain foods and drinks affect both systems. Caffeine and alcohol, for instance, relax the lower esophageal sphincter, the muscle that prevents stomach acid from flowing back up, thereby increasing the risk of heartburn. At the same time, these substances are stimulants that can directly increase heart rate and trigger palpitations, creating a double effect.
Consuming large or high-fat meals contributes to both issues by delaying stomach emptying and increasing acid production, leading to reflux. Furthermore, a full stomach or gas can physically push up against the diaphragm, which in turn can irritate the nerves near the heart and provoke an irregular beat. Lying down too quickly after eating is a common behavior that exacerbates both acid reflux and the likelihood of experiencing these combined symptoms.
Differentiating Palpitations from Cardiac Emergencies
While the link between heartburn and a racing heart is real, it is important to recognize that chest pain and palpitations can also be symptoms of a serious cardiac event, such as a heart attack. The benign nature of reflux-induced palpitations means they usually resolve once the acid reflux is controlled or the trigger is removed. However, certain “red flag” symptoms must prompt immediate emergency medical attention.
Symptoms that are highly concerning and not typically associated with simple acid reflux include:
- Chest pain described as a squeezing, crushing, or pressure sensation that lasts for more than a few minutes.
- Pain that radiates to the jaw, shoulder, back, or down one or both arms.
- The sudden onset of severe shortness of breath.
- Unexplained cold sweats.
- Feelings of lightheadedness or dizziness.
If heart palpitations are accompanied by fainting or near-fainting spells, this warrants an urgent call to emergency services. Because it can be difficult to distinguish between severe heartburn and a heart attack, medical professionals advise seeking immediate help if there is any doubt about the cause of the symptoms.