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Are an Irregular Heartbeat and GI Problems Related?

Are an Irregular Heartbeat and GI Problems Related?

Are an Irregular Heartbeat and GI Problems Related?

Many people experience heart palpitations after eating certain foods or a heavy meal, and for some, the co-occurrence of an irregular heartbeat and gastrointestinal problems is even more pronounced.

But if your heart pounds, races, does flip flops, or appears to miss beats, how do you know if you have a structural heart disease or whether digestive complaints could be to blame? The phenomenon of “gastrocardiac syndrome” is still something of a mystery to researchers, but treating digestive issues often seems to help heart symptoms improve.

Possible Connections Between Gastrointestinal Symptoms and Cardiac Symptoms

The co-occurrence of digestive discomfort and an irregular heartbeat has popped up from time to time in the medical literature, but it’s still not 100% clear whether one causes the other, or whether both stem from a common cause.

Roemheld Syndrome

A connection between cardiac symptoms and gastrointestinal symptoms was first written about in 1913 when Dr. Ludwig von Roemheld studied the occurrence of cardiac symptoms such as chest pain, shortness of breath, skipped beats, nausea, arrhythmias, and palpitations in patients with gastrointestinal problems.

Instead of evidence of heart disease, these patients had digestive issues, including:

  • Acute pancreatic necrosis
  • Bowel obstruction
  • Enteric disease
  • Hiatal hernia
  • Lactose intolerance
  • An inability to burp
  • Abnormal gallbladder function

It was hypothesized that the digestive and cardiac symptoms were connected via the nervous system—specifically, the vagus nerve, which is the main set of nerves in the parasympathetic nervous system that affects digestion, heart rate, and the immune system.

In medical terms, vagal stimulation reduces the atrial-effective refractory period of a heartbeat, which predisposes the patient to short-term or “paroxysmal” atrial arrhythmias.

It was also observed that patients with Roemheld Syndrome had more gas caught inside their digestive systems, possibly due to taking in more air when eating and drinking. Because of this, patients could be diagnosed with Roemheld Syndrome if a colon X-ray showed excessive air in the large intestine while an irregular heartbeat was present.

Functional Dyspepsia

Fast forward to the 21st century, and research on the gastrocardiac connection has focused mostly on case studies.

In one case study entitled “Recurrent Episodes of Paroxysmal Supraventricular Tachycardia Triggered by Dyspepsia” (2021), a 54-year-old woman presented at the emergency room with a heart rate of 220 bpm and the uncomfortable sensation of being able to feel her heart beating. This episode followed 20 hours of severe dyspepsia, including bloating, abdominal distension, and nausea.

After giving the woman medication to restore a normal sinus rhythm and conducting extensive cardiac and gastrointestinal testing—which showed no abnormalities—the doctors concluded that her symptoms were a result of functional dyspepsia. After adding omeprazole 40 mg to her daily prescriptions and modifying her eating and exercise habits, the woman’s cardiac symptoms improved.

Statistical Comorbidities

Another way we can see a connection between irregular heartbeats and gastrointestinal problems is by observing overlaps between cardiac and gastrointestinal diagnoses.

  • Patients with gastroesophageal reflux disease (GERD) are 0.62-14% more likely to suffer from atrial fibrillation (AF). Possible causes include the proximity of the left atrium to the esophagus, gastrointestinal inflammation leading to systemic inflammation, and problems with autonomic nervous system stimulation.
  • Active inflammatory bowel disease has been associated with a heightened risk of atrial fibrillation and stroke. Knowing this, taking steps to treat or manage gastrointestinal system disorders may actually reduce one’s cardiac risk.
  • Poor dietary and lifestyle habits increase a person’s risk for GI disorders and heart disease. Many of the recommended steps to reverse heart disease and prevent cardiac arrest are likely to help with GI symptoms as well.

Other Connections Between Irregular Heartbeats and Digestive Symptoms

In addition to the examples given above, there are cases in which a common cause triggers both gastrointestinal and cardiac symptoms, irrespective of any direct connection.

  • Alcohol, caffeine, and overeating can cause GERD symptoms as well as heart palpitations. The heart palpitations that are felt after eating are usually extra beats—either premature atrial contractions (PACs) or premature ventricular contractions (PVCs)—rather than true atrial fibrillation.
  • Anxiety and stress can cause indigestion and heart palpitations.
  • Infection with the H pylori bacterium can cause both chronic gastritis and persistent atrial fibrillation.
  • People who are obese have a higher risk of sleep apnea, which in turn increases the amount of air ingested and the likelihood of gastrocardiac syndrome.

What to Do If You Experience Digestive Issues and an Irregular Heartbeat

If you frequently experience heart palpitations or an irregular heartbeat in conjunction with indigestion or acid reflux, what should you do?

Unless you’re also experiencing chest pain, shortness of breath, dizziness, or tightness in the chest, back, neck, or jaw, it’s probably not a medical emergency (if you do experience any of these symptoms with palpitations, seek medical attention immediately).

Usually, the first thing you would be advised to do is start a food diary that details:

  • What you ate
  • What you drank
  • When you smoked tobacco or cannabis (if relevant)
  • Medications and supplements you took
  • Your emotional state
  • Your digestive symptoms
  • Your heart rate, blood pressure, and any additional cardiac symptoms

With this information in hand, you might be able to identify specific foods, beverages, or substances that aggravate your digestive symptoms and also bring on heart palpitations.

Foods and Beverages that Trigger Palpitations

Foods to avoid if you have an irregular heartbeat typically include sugary, salty, high-carb, or fatty foods, caffeine, alcohol, spicy foods, and smoking, although you may identify other foods that are a trigger for you. Certain herbs, supplements, and medications can also trigger palpitations.

Foods and Beverages that Trigger Digestive Discomfort

Foods that often exacerbate digestive symptoms include processed dairy, processed oils, fruit and fruit juice, carbonated beverages, refined grains, gluten (if you’re intolerant), and foods that contain “fermentable oligosaccharide, disaccharide, monosaccharide, and polyols” (FODMAPs).

It’s interesting to note that a low FODMAP diet has been shown to help a majority of patients with irritable bowel syndrome (IBS) due to a reduced osmotic load and reduced gas production. While the long-term nutritional effects of this diet are unknown, reduced gas production might help with gastrocardiac symptoms that are caused by excessive gas.

If Symptoms Persist

If you keep a food diary, reduce or eliminate common trigger foods, and still have heart palpitations or an irregular heartbeat, it’s a good idea to see your doctor.

To find out what’s causing the problem, your doctor may order:

  • Blood tests to check for anemia and thyroid problems
  • An electrocardiogram (ECG or EKG) to record the heart’s rhythm
  • An echocardiogram to view the structure of the heart
  • A stress test
  • A Holter monitor
  • Other tests

If a connection between gastrointestinal symptoms and cardiac symptoms is suspected, you might also have GI tests, including:

  • An endoscopy
  • A colonoscopy
  • A stomach ultrasound

Depending on what these tests reveal, you may be prescribed medications, such as proton pump inhibitors (PPIs) or anticonvulsants to reduce your GI symptoms, and medications like beta-blockersto help you maintain a regular heart rhythm.

You may also be advised to eat smaller, more frequent meals, minimize your intake of sugary, fatty, and salty foods, minimize your intake of gluten and dairy, and exercise regularly (as per the advice given to the 54-year-old woman in the case study cited earlier on).

If you do have heart disease or a structural heart problem, you may be advised to make dietary and lifestyle changes, take medications, keep an AED like the Philips HeartStart FRx or LIFEPAK CR2 at home, have an implantable cardioverter defibrillator installed, or have a heart ablation.

If you do have a heart condition, these therapies can help to stabilize an irregular heartbeat and improve the length and quality of your life.

Get to the Root Cause of GI and Cardiac Issues

While researchers continue to explore the finer details of the connection between gastrointestinal problems and an irregular heartbeat, what we can observe is that improving one’s digestion through dietary and lifestyle changes has direct as well as indirect benefits for your heart health.

If you aren’t experiencing any emergency symptoms (such as chest pain or shortness of breath) but have heart palpitations related to digestion, you can start a food diary, reduce or eliminate some of the common trigger foods, and talk with your doctor. The work you put into exploring these aspects of your health now can help you prevent more serious heart issues down the road.

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