the Link Between GERD and Heart Palpitations - Gastroenterology and Hepatology

Q: the Link Between GERD and Heart Palpitations

Hello： Large studies have shown a relationship between symptoms such as angina, myocardial infarction, arrhythmias, and gastroesophageal reflux disease (GERD). <br>If we can prevent or alleviate episodes of GERD, it may also reduce symptoms such as chest pain, chest tightness, an

Gastroesophageal reflux can cause arrhythmias?

Hello, Doctor: Last year, I first experienced these symptoms and underwent examinations at the cardiology department, including an echocardiogram, X-ray, and 24-hour heart rate monitoring, all of which showed normal cardiac function.
Later, after discussing with the doctor, we noted that these symptoms occurred during sleep, often after having a late-night snack.
I also have a habit of sleeping on my stomach or on my left side.
When I press on certain areas of my left chest, particularly over the esophagus, I feel significant pain.
The doctor suspected a higher likelihood of gastroesophageal reflux disease (GERD).
Subsequently, I consulted a gastroenterologist who performed an endoscopy and confirmed excessive gastric acid secretion and inflammation in the esophagus.
This year marked my first recurrence of symptoms.
After sitting up straight and taking deep breaths for about ten minutes, my palpitations and arrhythmia subsided.
I suspect that my recent lower back pain, for which the orthopedic doctor prescribed two medications: Mephenoxalone 200 mg and Acemetacin 60 mg, may be contributing to my discomfort.
I experienced gastric discomfort after taking these medications, followed by pain when swallowing.
Although I took the medications within 30 minutes after meals, I still could not avoid excessive gastric acid irritation.
Should I request that my doctor prescribe a gastric protective agent along with these medications to alleviate discomfort?
In previous discussions online with a cardiologist, he mentioned that there are indeed clinical cases like mine, and he referred to a professional term: referral pain or irritation.
I have also experienced heartburn and a burning sensation, but these symptoms do not occur simultaneously with palpitations.
However, I do have a noticeable foreign body sensation in my throat or esophagus.
I would like to ask if gastroesophageal reflux can produce different results depending on the area of irritation? For instance, could my situation be due to esophagitis indirectly stimulating the sympathetic nerves in the chest, causing palpitations? Or should I undergo further detailed cardiac examinations?
Lastly, when experiencing arrhythmia and palpitations, aside from sitting up straight to avoid further gastric acid irritation, is it advisable to drink water or take other medications (like Metoclopramide or Mosapride) to help with gastric motility and empty the stomach of acid? I have many questions...
Thank you, Doctor.

A-Hong, 20~29 year old female. Ask Date: 2013/03/17

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello: Large studies have shown a relationship between symptoms such as angina, myocardial infarction, arrhythmias, and gastroesophageal reflux disease (GERD).
If we can prevent or alleviate episodes of GERD, it may also reduce symptoms such as chest pain, chest tightness, and palpitations.
Best regards, Dr.
Chi-Feng Chen, Taoyuan General Hospital, Department of Health.

Reply Date: 2013/03/17

More Info

Understanding the connection between gastroesophageal reflux disease (GERD) and heart palpitations can be quite complex, as both conditions can share overlapping symptoms and may influence each other. In your case, it seems that your symptoms of heart palpitations and discomfort in the chest area are closely tied to your experiences with GERD, particularly after eating and during certain sleeping positions.

GERD occurs when stomach acid frequently flows back into the esophagus, leading to irritation and inflammation. This can cause symptoms such as heartburn, regurgitation, and chest pain. The chest pain associated with GERD can sometimes mimic cardiac pain, leading to confusion and concern about heart-related issues. This phenomenon is often referred to as "referred pain," where pain is perceived in an area different from its actual source. In your case, the irritation of the esophagus due to acid reflux could indeed stimulate the vagus nerve, which can affect heart rate and potentially lead to palpitations.

Your description of experiencing palpitations during sleep, particularly after eating, aligns with common patterns seen in GERD patients. The act of lying down can exacerbate reflux symptoms, as gravity no longer helps keep stomach contents in place. Additionally, certain sleeping positions, such as lying on your left side, may put pressure on the stomach and esophagus, further promoting reflux and its associated symptoms.

Regarding your medication for back pain, it is essential to communicate with your healthcare provider about any gastrointestinal side effects you experience. Nonsteroidal anti-inflammatory drugs (NSAIDs) like acemetacin can irritate the stomach lining and exacerbate GERD symptoms. It would be reasonable to discuss the possibility of co-prescribing a proton pump inhibitor (PPI) or an H2 blocker to help manage stomach acid levels while you are on these medications.

When it comes to managing your symptoms during episodes of heart palpitations and discomfort, sitting upright can indeed help alleviate pressure on the stomach and reduce acid reflux. Drinking water may provide temporary relief, as it can help wash down any acid that has refluxed into the esophagus. However, be cautious with the timing of any medications you take, as some may require specific intervals after meals to be effective.

If your symptoms persist or worsen, it would be prudent to consult with your cardiologist for further evaluation. While your previous tests showed normal heart function, ongoing symptoms warrant a thorough investigation to rule out any underlying cardiac issues. Continuous monitoring of your heart rhythm, especially during episodes of palpitations, can provide valuable insights into whether these events are related to GERD or if they stem from a separate cardiac condition.

In summary, GERD can indeed lead to heart palpitations through mechanisms involving nerve stimulation and referred pain. It is crucial to manage both your gastrointestinal symptoms and any cardiac concerns in tandem. Open communication with your healthcare providers about your symptoms, medications, and any changes you experience will be key to finding an effective management plan.

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