Frequently Asked Questions about Roemheld Syndrome
Not exactly.
PVC stands for Premature Ventricular Contraction. It is an extra heartbeat that starts in the lower chambers of the heart (the ventricles) and occurs earlier than expected.
Many people describe a PVC as:
- A skipped beat
- A missed heartbeat
- A sudden thump in the chest
- A flutter or flip-flop sensation
- A brief pause followed by a stronger heartbeat
Palpitations is a broader term. It simply means that you are unusually aware of your heartbeat. Palpitations can be caused by PVCs, but they can also be caused by anxiety, exercise, caffeine, stress, a fast heart rate, or many other conditions.
In other words:
- A PVC can cause palpitations.
- Not all palpitations are PVCs.
How Do I Know If I Have PVCs?
It is impossible to know for certain based on symptoms alone. While many people can accurately describe the sensation of a PVC, confirmation usually requires a heart rhythm recording such as:
- An ECG (electrocardiogram). A quick test that records the electrical activity of your heart, usually over a few seconds. It can help detect PVCs, arrhythmias, heart attacks, and other heart conditions, but only if they occur while the recording is being made.
- A Holter monitor. A portable ECG device that continuously records your heart rhythm for 24 to 72 hours (sometimes longer) while you go about your normal daily activities. It is often used when symptoms occur regularly but may not be present during a standard ECG.
- An event recorder. A portable heart monitor designed for symptoms that occur only occasionally. Depending on the device, it may record automatically when an abnormal rhythm is detected or when you press a button after experiencing symptoms. Some event recorders can be worn for weeks or even months.
- A wearable ECG device, such as an Apple Watch used with an ECG app, can record a short heart rhythm strip, usually around 30 seconds. This can be useful for event monitoring, especially when symptoms come and go, because the recording can be made at the moment symptoms occur.
If you are experiencing new, worsening, or concerning heart symptoms, you should always consult a healthcare professional for proper evaluation.
Redactionele Opmerking: PVCs are common and are often harmless, even in healthy individuals. However, because symptoms such as chest pain, dizziness, shortness of breath, or fainting can also be caused by more serious heart conditions, they should never be automatically attributed to Roemheld Syndrome without medical assessment.
In most cases, PVCs are not dangerous.
PVCs are very common and can occur in people with completely healthy hearts. Many people experience occasional PVCs without even noticing them. In these situations, PVCs are generally considered benign and do not require treatment.
However, the answer is not always straightforward. The significance of PVCs depends on factors such as how often they occur, whether there is underlying heart disease, and whether they are associated with other symptoms. Frequent PVCs, complex arrhythmias, or PVCs occurring in people with known heart conditions may require further evaluation by a cardiologist.
Many people with PVCs report feeling tired, weak, or drained. While an individual PVC may briefly reduce the efficiency of a heartbeat, occasional PVCs do not usually reduce blood flow enough to cause significant fatigue. However, frequent PVCs, disturbed sleep, constant symptom awareness, stress, and adrenaline release can all contribute to feelings of exhaustion.
It is also important to remember that the way PVCs feel and the medical significance of PVCs are not always the same thing. A person may experience severe symptoms from PVCs that are medically benign, while another person may have frequent PVCs and hardly notice them at all.
Redactionele Opmerking: If you experience new palpitations, chest pain, shortness of breath, dizziness, fainting, or a sudden increase in PVCs, you should seek medical evaluation. Only a healthcare professional can determine whether PVCs are harmless or require further investigation. prevalence figures for Roemheld Syndrome. One of our goals of is to increase awareness and encourage further scientific research into this under-studied condition.
Apple Watch ECG recordings are generally considered accurate for detecting certain heart rhythm abnormalities and can be a useful tool for documenting symptoms as they occur. Many cardiologists review Apple Watch ECG recordings as part of the diagnostic process. They are often very useful because many patients report symptoms that occur unpredictably—after meals, when lying down, or during episodes of bloating—making it difficult to capture them on a standard ECG performed in a clinic.
However, the Apple Watch is not a replacement for medical-grade ECG equipment. It records only a single ECG lead for a short period (typically 30 seconds), whereas a hospital ECG uses 12 leads and provides much more information. Some rhythm abnormalities may be missed, and the device cannot diagnose all heart conditions.
For people experiencing intermittent symptoms such as palpitations, PVCs, PACs, or episodes of rapid heart rate, an Apple Watch ECG can be particularly useful because it allows a recording to be made at the exact moment symptoms occur, thus acting as 30 second “event recorder”. At the time of writing (2026), Apple Watches from Series 7 and up are still supported by Apple. Note: the native Apple ECG-function may, in some cases, give an “inconclusive” outcome. In order to interpret the ECG’s, you can either export the PDF’s and let a good AI-Model interpret it, or you can use a ECG-app.
Redactionele Opmerking: An Apple Watch ECG should be viewed as a helpful screening and monitoring tool, not as a substitute for professional medical evaluation. Any concerning symptoms should be discussed with a healthcare professional.
The honest answer is: nobody knows.
Unlike many other medical conditions, there are currently no large population studies that tell us how common Roemheld Syndrome is. Most of the published medical literature consists of individual case reports, small observational studies, and review articles.
Some researchers believe the condition may be under-recognized because patients are often evaluated separately for heart symptoms and digestive symptoms, without considering a possible connection between the two.
At the same time, it is important not to assume that every person with palpitations, PVCs, reflux, bloating, or a hiatal hernia has Roemheld Syndrome. These symptoms are common and can have many different causes.
What we do know is that thousands of patients around the world report a similar pattern of symptoms involving both the digestive system and the heart. Whether this represents a common but underdiagnosed condition remains an open question that requires further research.
Redactionele Opmerking: At present, there are no reliable prevalence figures for Roemheld Syndrome. One of our goals of is to increase awareness and encourage further scientific research into this under-studied condition.
Many people with suspected Roemheld Syndrome report that symptoms such as palpitations, chest pressure, shortness of breath, or a feeling of a racing heart improve after burping.
One possible explanation is that burping helps release excess gas from the stomach. This may reduce stomach distension and decrease pressure on the diaphragm and surrounding structures within the chest and upper abdomen.
Researchers have also suggested that the digestive system and heart are connected through the autonomic nervous system, including the vagus nerve. In some individuals, reducing stomach pressure may lessen signals that contribute to heart-related symptoms.
It is important to note that the exact mechanism is not yet fully understood, and not every patient experiences relief after burping. However, the observation is so commonly reported by patients that it has become one of the characteristic features associated with Roemheld Syndrome.
Redactionele Opmerking: Relief after burping does not prove that a person has Roemheld Syndrome. Similar symptom patterns can occur in other gastrointestinal and cardiac conditions. Any persistent or concerning symptoms should be discussed with a healthcare professional.
Yes. Roemheld Syndrome is sometimes mistaken for an anxiety disorder because many of the symptoms overlap. Palpitations, a racing heart, chest discomfort, shortness of breath, dizziness, and a sense of impending doom can occur in both conditions.
This can be particularly confusing when heart tests appear normal. As a result, some patients are told that anxiety is the primary cause of their symptoms.
However, many people with suspected Roemheld Syndrome notice a clear connection between their symptoms and digestive triggers such as eating, bloating, reflux, excessive gas, constipation, or a hiatal hernia. In these cases, anxiety may be a consequence of the symptoms rather than the original cause.
At the same time, anxiety and Roemheld Syndrome are not mutually exclusive. Living with unexplained or frightening physical symptoms can understandably lead to stress, worry, or panic, which may further amplify symptoms and create a vicious cycle.
Redactionele Opmerking: Being diagnosed with anxiety does not automatically rule out a gastrointestinal contribution to symptoms, just as the presence of digestive symptoms does not rule out anxiety. A thorough medical evaluation should consider both physical and psychological factors.
No. The symptoms experienced by people with suspected Roemheld Syndrome are very real.
Many patients report physical symptoms such as palpitations, PVCs, chest discomfort, shortness of breath, dizziness, bloating, and reflux. While the exact mechanisms are still being studied, medical literature has described several ways in which gastrointestinal problems may influence heart rhythm and cardiovascular symptoms.
That said, anxiety and stress can play an important role. Living with unexplained heart symptoms can be frightening, and anxiety may increase awareness of heartbeats, trigger adrenaline release, and amplify existing symptoms. This can create a vicious cycle in which physical symptoms cause anxiety, and anxiety in turn makes the symptoms feel worse.
Importantly, this does not mean the symptoms are imaginary or purely psychological. Physical symptoms and anxiety can exist at the same time, and each may influence the other.
Redactionele Opmerking: Patients with chest pain, palpitations, shortness of breath, dizziness, or fainting should always seek appropriate medical evaluation. Potential cardiac causes should be ruled out before symptoms are attributed to Roemheld Syndrome or any other gastrointestinal condition.
For some people, yes. For most people: no.
Many patients report that certain forms of exercise can trigger or worsen symptoms such as palpitations, PVCs, chest discomfort, shortness of breath, reflux, or a sensation of pressure in the chest.
One possible explanation is that exercise can increase pressure within the abdomen, particularly during activities such as weightlifting, heavy resistance training, or exercises that involve straining. This increased pressure may contribute to reflux, stomach distension, or upward pressure on the diaphragm in susceptible individuals.
Exercise also changes breathing patterns and heart rate. In some people, especially those already experiencing digestive symptoms, these changes may make heart-related sensations more noticeable.
However, exercise affects people differently. While some patients find that heavy activity triggers, such as weightlifting, triggers symptoms, others report that regular walking, cycling, swimming, or other moderate exercise improves their overall wellbeing and reduces symptoms over time.
Redactionele Opmerking: Exercise is generally considered beneficial for overall cardiovascular and digestive health. If exercise consistently causes chest pain, severe shortness of breath, dizziness, fainting, or concerning heart rhythm symptoms, medical evaluation is recommended before continuing strenuous activity.
Possibly.
Although sleep apnea and Roemheld Syndrome are different conditions, some researchers and patients believe there may be an overlap in certain individuals. Both conditions can be associated with symptoms such as palpitations, irregular heartbeats, poor sleep quality, fatigue, shortness of breath, and anxiety.
Sleep apnea causes repeated interruptions in breathing during sleep. These interruptions can place stress on the cardiovascular system, affect oxygen levels, and increase the risk of certain heart rhythm disturbances.
Some patients with suspected Roemheld Syndrome report that their symptoms improve after treatment for sleep apnea, while others notice no significant change. At present, there is very little research specifically examining the relationship between sleep apnea and Roemheld Syndrome.
Redactionele Opmerking: Sleep apnea is a common and potentially serious medical condition that often goes undiagnosed. Symptoms such as loud snoring, gasping during sleep, morning headaches, excessive daytime sleepiness, or waking up feeling unrefreshed should be discussed with a healthcare professional.
- Around 10–20% of adults have a hiatal hernia.
- In people over 50 years of age, prevalence may rise to 30–60%.
- Many people have a small hiatal hernia and never experience symptoms.
- A significant number of hiatal hernias are discovered incidentally during endoscopy, CT scans, or other investigations.
So yes, hiatal hernias are common, particularly in older adults. Many people with a hiatal hernia experience no symptoms at all and may never know they have one. However, in some individuals, a hiatal hernia has been associated with reflux, chest discomfort, palpitations, arrhythmias, and other symptoms commonly reported by people with suspected Roemheld Syndrome. Research is ongoing to better understand why some people develop symptoms while others do not.
Redactionele Opmerking: most people with Roemheld Syndrome do not ask “Do I have a hiatal hernia?” until after they start noticing palpitations after meals, bending over, bloating, or lying down. That’s often what leads to the discovery of the hernia in the first place.
Roemheld Syndrome may be a symptom complex with multiple possible gastrointestinal triggers, rather than a single disease with a single cause. Some patients have reported that a weak lower esophageal sphincter (LES dysfunction) might also contribute to symptoms, as it can allow stomach acid and gas to move more easily into the esophagus, potentially increasing reflux, bloating, belching, and chest discomfort. However, its specific role in Roemheld Syndrome has not yet been formally studied.
Vagus nerve stimulation (VNS) is a medical treatment that uses electrical impulses to stimulate the vagus nerve. It is currently approved for certain conditions, including epilepsy and treatment-resistant depression.
Researchers have proposed that the vagus nerve may play an important role in Roemheld Syndrome because it forms part of the communication network between the digestive system and the heart. Some theories suggest that stomach distension, reflux, or other gastrointestinal disturbances may influence heart rhythm and cardiovascular symptoms through vagal pathways.
At present, however, there is no clinical evidence that VNS is an established treatment for Roemheld Syndrome, and its use for this purpose remains speculative.
Editor’s Note
The vagus nerve is frequently mentioned in discussions about Roemheld Syndrome and the gut-heart connection. While researchers continue to investigate its role, much remains unknown. Patients should be cautious about claims that vagus nerve stimulation devices or therapies have been proven to treat Roemheld Syndrome.
We’d love to hear from you! Here is our contact page
Ludwig Roemheld (1871–1938) was a German physician who worked in internal medicine during the early twentieth century. In 1912, he published a paper entitled Der gastro-kardiale Symptomenkomplex, eine besondere Form sogenannter Herzneurose (“The Gastro-Cardiac Symptom Complex, a Special Form of So-Called Cardiac Neurosis”).
In this paper, Roemheld described a group of patients who experienced heart-related symptoms such as palpitations, extrasystoles, chest discomfort, and rapid heartbeat that appeared to be linked to disturbances of the digestive system.
Although relatively little biographical information about Roemheld has survived, his observations became well known in German-speaking medicine and eventually gave rise to the term Roemheld Syndroom.
More than a century later, his work continues to be cited in discussions about the relationship between the digestive system and the heart.
The condition is named after Ludwig Roemheld because he was the first physician known to publish a detailed description of what he called the gastro-cardiac symptom complex in 1912.
Roemheld observed that some patients developed symptoms that appeared cardiac in origin—such as palpitations, extrasystoles, chest pressure, dizziness, and episodes of rapid heartbeat—but that these symptoms often seemed to be associated with digestive disturbances, abdominal bloating, and gas accumulation beneath the diaphragm.
Over time, other physicians began referring to this pattern of symptoms as Roemheld Syndroom or Gastrocardiac Syndrome in recognition of his work.
Although the condition is not universally recognized as a formal medical diagnosis today, Roemheld’s name remains closely associated with the concept that disturbances of the digestive system may sometimes contribute to symptoms that are perceived as heart-related.
Some do, while others remain the subject of ongoing debate.
What is remarkable is how many of the symptoms described by Roemheld in 1912 are still reported by patients today. These include palpitations after meals, premature heartbeats (extrasystoles), symptoms triggered by bloating, worsening symptoms after lying down, and relief after belching or passing gas.
However, modern medicine does not fully accept Roemheld’s original explanation. Roemheld primarily believed that excessive gas beneath the diaphragm physically altered the position of the heart and contributed to symptoms. Today, researchers are also investigating additional mechanisms involving the vagus nerve, hiatal hernia, gastroesophageal reflux disease (GERD), autonomic nervous system dysfunction, and inflammation.
As a result, many experts view Roemheld’s work as an important historical foundation rather than a complete explanation.
More than 100 years later, the relationship between the digestive system and heart-related symptoms remains an active area of research, and many questions are still unanswered.