The relationship between cardiac and gastrointestinal disease is widely regarded as being a complex one – disorders of the two systems commonly co-exist, and the symptoms of angina pectoris are notoriously difficult to differentiate from gastro-oesophageal problems. In addition, it has commonly been observed that patients suffering with gastrointestinal disturbance suffer from cardiac symptoms whose aetiology can be attributed to their primary gut problems. Recent evidence has shown that this is a relatively common manifestation and that the incidence of these secondary cardiac complications has been underestimated in patients with gastroenterological disease. This article reviews the evidence for secondary cardiological complications of gastrointestinal disorders and discusses the potential mechanisms behind them. The three main areas outlined in the review include rhythm disturbances related to oesophageal disease, linked angina and the cardiac manifestations of inflammatory large bowel disorders.