Can heartburn cause palpitations of the heart?

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Heartburn is the most common symptom of gastroesophageal reflux disease (GERD, a condition in which acid from the stomach splashes up into the esophagus. The acid leads to a burning sensation in the esophagus, felt as heartburn. Other symptoms may include regurgitation of food, a sour taste in the back of the throat or mouth, chest pain and occasionally coughing or asthma-like symptoms.

GERD can also cause chest pain because the acid inflames the esophagus and can lead to abnormal muscle contractions. This chest pain may feel very similar to the pain experienced in angina -- the pain felt by patients with coronary heart disease.

Although it does not cause heart palpitations directly, GERD-related chest pain may cause the patient to feel very anxious, and this may cause palpitations. Alternatively, a patient may actually be experiencing an attack of heart-related pain, or angina. In this situation, palpitations may be a direct result of a heart attack. Other symptoms that might indicate heart problems rather than GERD include nausea and shortness of breath.

In patients who may be at risk for cardiac disease, it is very important to rule out angina before assuming GERD is responsible for chest pain and palpitations. Even pain that feels like typical heartburn may be a sign of cardiac disease in such patients, so a careful history and evaluation is required.