Can GERD cause heart palpitations like a heart attack at 22?

Question

Hello doctor,

I am 22 years old and have severe acidity and chest burning almost daily. Sometimes after meals, my heart starts racing, and I feel tightness, which feels like a heart attack. Can GERD cause heart palpitations that feel like a heart attack at 22? My ECG and ECHO were normal, and troponin was negative in the emergency room.

The acid reflux score was high on endoscopy. Anxiety seems to make it worse. These episodes make me rush to the emergency room often, even when tests are normal. My blood pressure also rises during these attacks, which scares me more. Sometimes I burp a lot before the palpitations start, which makes me think it is stomach-related, but fear still takes over.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

It is understandable that these symptoms feel frightening, especially when they resemble a heart attack. However, the normal electrocardiogram (ECG), echocardiogram (ECHO), and negative troponin are strong indicators that the heart is not the underlying cause.

Gastroesophageal reflux disease (GERD) can cause sensations that mimic heart palpitations or even a heart attack. The esophagus is located close to the heart, and when acid reflux irritates it, the brain may interpret this as chest tightness or cardiac discomfort.

In addition, reflux can stimulate the vagus nerve, which may temporarily influence heart rate and create a sensation of pounding or irregular beats. The presence of burping before the palpitations suggests that gas and reflux are contributing factors.

A distended stomach due to gas can exert upward pressure, leading to chest discomfort and increased awareness of heartbeats.

Anxiety can further intensify these symptoms. Once the sensation begins, the body may enter a fight-or-flight response, releasing adrenaline. This can increase heart rate, raise blood pressure (BP), and cause further chest tightness.

This creates a cycle where reflux triggers discomfort, discomfort triggers anxiety, and anxiety amplifies the physical symptoms. Panic attacks can overlap with GERD in this manner, especially when symptoms occur suddenly and lead to repeated emergency room visits.

The rise in blood pressure during these episodes is also consistent with anxiety-related adrenaline surges rather than a primary cardiac issue. At this age, with a normal cardiac evaluation, the likelihood of a heart attack is extremely low. However, the symptoms are genuine and require proper management.

Management typically involves a combined approach. Treating reflux with medications such as proton pump inhibitors, for example, Omeprazole or Pantoprazole, can help reduce acid production. Lifestyle modifications such as eating smaller meals, avoiding lying down immediately after eating, and reducing trigger foods like spicy or fatty meals are also beneficial.

At the same time, addressing anxiety through relaxation techniques, breathing exercises, or short-term therapy or medication may help break the cycle and prevent escalation of symptoms. During an episode, it may help to remember that prior cardiac evaluations have been normal. This reassurance can reduce the intensity of anxiety. Over time, as confidence improves and episodes pass without harm, their frequency and severity often decrease.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.