For most people, the term "acid reflux" goes hand in hand with heartburn. That’s because the burn of the acid is likely to be felt in the lower portion of the esophagus, in the region of the heart. But acid reflux can also cause heart palpitations and other disturbances, such as chest pain. There is one huge caveat, however: If you experience chest pressure or pain and palpitations, it is extremely important that these symptoms be taken seriously and not be automatically attributed to heartburn, since they may also signal a heart attack.
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Acid Reflux, Anxiety and Palpitations
Heart palpitations are described as racing or pounding heartbeats, a fluttery or sinking feeling in the chest cavity and the sensation of the heart beating irregularly. In people with chronic and severe acid reflux, known as gastroesophageal reflux disease (GERD), stress and anxiety are often associated and they may even be more prone to panic or depression, all of which can contribute to the perception of heart palpitations. They may worry that their symptoms are caused by something much more serious, and this can trigger anxiety. Sometimes this combination of troubles presents at nighttime, when stress together with discomfort from GERD seem to conspire against the calm needed to fall asleep. People may also be more aware of their heartbeat at night when going to bed.
Substances, Medications, Anxiety and GERD
Certain substances are associated with both acid reflux and premature ventricular contractions, or PVCs, which are commonly felt as "skipped heartbeats." Too much caffeine aggravates acid reflux and can also cause palpitations. Heavy alcohol consumption can trigger both acid reflux and PCVs -- and other heart rhythm abnormalities such as atrial fibrillation, especially in susceptible individuals. GERD and asthma may occur together in the same person, and GERD can actually worsen the asthma; the symptoms of asthma can cause anxiety in and of themselves, but nervousness and racing and pounding heartbeat are also among the potential side affects of airway-opening asthma medications such as albuterol.
Chest Distress and the Esophagus
GERD is one of the main causes of noncardiac chest pain, or NCCP, which can mimic a heart attack and is related to the sensation of palpitations. The same set of nerves supplies the heart and the esophagus, and so it's hard to know which is the source of the discomfort. Simply put, if you think something's wrong with your heart, the anxiety this causes might bring on palpitations. However, it is important to note that palpitations are one of many potential symptoms of an actual heart attack. NCCP may be described as a squeezing or burning pain below the sternum, which may radiate to the back, neck, arms and jaws. This is one of the reasons why it is so important to know your risk factors for heart disease and take symptoms such as chest pain or pressure and palpitations seriously.
Precautions and Warnings
Based on symptoms alone, it can be difficult for doctors to tell whether heart palpitations and chest pressure or pain are being triggered by GERD or if they signify a serious heart condition. If you are experiencing chest symptoms such as palpitations, pressure or pain, it is important to be evaluated by a qualified healthcare provider as soon as possible. Heart involvement must be ruled out before GERD is explored as the possible cause.
Medical advisor: Jonathan E. Aviv, M.D., FACS