The cause might be hiatus hernia and reflux esophagitis (gastro esophageal reflux disease – GERD). Hiatus hernia is a common condition. In hiatus hernia, there is a herniation of the upper part of stomach into thorax through the esophageal hiatus because of weakness in the diaphragm resulting in reflux esophagitis (GERD). GERD often causes heartburn. Palpitation can occur due to irritation of vagus nerve. Advice 1. Omeprazole 20 mg per oral empty stomach in the morning for 10 days 2. Quit smoking and alcohol 3. Do not heavily at a time. Divide your meals into smaller portions and eat them frequently during the day 4. Avoid a particular food if pain occurs particularly after eating that food. Allergy particularly occurs for dairy products 5. Avoid eating 3 hours before lying down 6. Raise the head of your bed 7. Avoid spicy foods, fatty foods, mint, chocolate, tomato-based foods, coffee, and citrus fruits If above symptoms do not respond to above treatment then go for below investigations a. Barium meal X – ray b. ECG Thanks