Heart palpitations have several possible causes. Acid reflux and gastroesophageal reflux disease (GERD) are unlikely to be one of them. However, you may be more likely to have heart palpitations if you have GERD.

Acid reflux is when the contents of your stomach, mainly acid, travel up your esophagus (food pipe), causing heartburn, a burning sensation in your chest. Persistent acid reflux may cause GERD, a chronic condition that requires medical management.

Acid reflux may manifest with different symptoms, some of which may mimic or trigger cardiac events. Some people with GERD experience heart palpitations, but is there a causal relationship between the two?

What is a heart palpitation?

A heart palpitation is when you feel your heart racing, fluttering, gurgling, or skipping a beat.

Heart palpitations are symptoms (sensations) of something going on in your heart or in another organ that communicates with it. Most of the time, they are harmless, but on some occasions, heart palpitations may signal a heart condition.

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A link may exist between acid reflux, GERD, and heart palpitations. Research shows a correlation, at best, but more evidence is needed to determine a cause-effect relationship.

An older study found that people with GERD have a 0.62% to 14% higher chance of experiencing atrial fibrillation (AFib) than those without GERD. AFib is a common heart arrhythmia (irregular heart rate), and its main symptom is heart palpitations. What exactly is behind this correlation isn’t clear at the moment.

A 2020 review also found a link between GERD and AFib mediated by the contributing factors they share.

Hiatal hernias, which often lead to GERD, may also be a trigger for heart palpitations related to AFib, when the hernia pushes against the heart.

Another small study from 2019 found that GERD is often associated with an increased risk of ventricular arrhythmias (VAs). VAs are abnormal heart rates originating in the two lower chambers of the heart. They may compromise blood flow to the rest of the body. VAs present with heart palpitations, among other symptoms.

Although it hasn’t been established, some experts have theorized that the potential relationship between GERD and heart palpitations is mediated by the vagus nerve. This nerve carries messages between the brain, heart, and digestive system.

When the vagus nerve is not working properly, symptoms like acid reflux and changes in heart rate may develop simultaneously.

Authors of the 2020 review mentioned before also postulated that the inflammation in the esophagus caused by acid reflux may lead to autonomic dysfunction, which refers to the sympathetic and parasympathetic systems not performing as they should. These systems regulate heart and digestive functions, among others.

The review also noted that proton pump inhibitors (PPIs), common GERD medications, often reduce the number of AFib episodes.

Although science hasn’t found that GERD causes heart palpitations, research has indicated that they often co-occur.

Heart palpitations can cause a fluttering sensation in the chest or a feeling that your heart has skipped a beat. You may also feel like your heart is beating too fast or is pumping harder than usual. Heart palpitations may also feel like a quick gurgling or pinching sensation in the chest.

One of the main symptoms of acid reflux and GERD is heartburn. This is a burning sensation or pain in your chest that may also manifest as chest tightness, radiating pain to the shoulders and arms, and a faster heart rate. This isn’t the same as having heart palpitations, though. The sensation comes from acid irritating your food pipe, and it isn’t related to your heart.

Learn about other symptoms of GERD.

Heart palpitations may have different causes. Some of these may include:

  • anxiety and panic attacks
  • caffeine intake
  • nicotine use
  • high fever
  • stress response
  • physical overexertion
  • hormonal changes
  • medication side effects

Heart palpitations related to these causes are usually sporadic and harmless. They may come and go in minutes, and you may feel them once or very rarely.

Heart palpitations may also result from heart-related conditions, from arrhythmias to heart disease. They are also an early sign of some heart conditions. These heart palpitations are more likely to occur frequently and with other heart-related symptoms.

Learn more about heart palpitations.

You may be more likely to experience palpitations if you have:

You may also have heart palpitations during pregnancy.

If you describe a heart palpitation to a doctor, they are likely to perform the following tests in addition to doing a physical exam:

Electrocardiogram (ECG)

During your first consultation, a doctor may perform an ECG. It can be done at the doctor’s office and doesn’t require any preparation on your part.

During this test, the doctor records your heart’s electrical impulses and tracks your heart rhythm. The test is painless and noninvasive.

Common types of ECGs include:

  • Holter monitor is a portable device that records your heart’s electrical impulses for 24 to 72 hours. It may have a button you press every time you feel a heart palpitation.
  • A stress test is when they connect you to an ECG monitor while performing a physical activity, like jogging.
  • An event recorder is a device similar to a Holter monitor, but it records your heart’s impulses only when you push a button while experiencing heart palpitations.
  • A loop recorder is a device that’s implanted under the skin and allows continuous monitoring from a distance.

Echocardiogram

Another noninvasive test is an echocardiogram, which includes an ultrasound of the chest cavity. The doctor will explore the shape and structure of your heart to determine if any changes have occurred that may explain the heart palpitations.

If a doctor can’t determine a heart-related challenge as the cause of the heart palpitations, they may start exploring other causes.

Read about GERD tests.

Acid reflux and GERD are unlikely to be a direct cause of heart palpitations. However, research shows that people with these conditions are statistically more likely to experience heart palpitations. Although it is not clear why this is the case, experts theorize it may be linked to GERD and heart disease sharing a few similar causes and risk factors.

If you experience a persistent fluttering, pinching, or gurgling sensation on your chest, it may be a good idea to consult a healthcare professional. They can determine the cause of this symptom as well as the next steps for both heart palpitations and GERD symptoms.