Fast heart rate hiccups may be caused by physiological reasons, but also may be caused by some diseases, such as reflux esophagitis, mediastinal lesions, intractable eructation and so on. 1. Physiological factors: fast heart rate hiccups may be caused by over-excited emotions or strenuous exercise, and may also be caused by fast heart rate hiccups after being cold or over-exerted. Generally, it will be improved after the emotion is stabilized or after getting enough rest. 2. Pathologic factors: (1) Reflux esophagitis: patients usually have the symptoms of acid reflux, heartburn, and some patients may also cause hiccups due to the feeling of foreign body in the throat. (2) Mediastinal lesions: it may be lesions caused by mediastinal abscess, primary mediastinal tumor, mediastinal Hodgkin’s lymphoma, etc. The patients mainly show symptoms of irregular breathing, weakness of limbs and mental instability, and some of them may have hiccups due to irritation of the diaphragm. (3) Intractable hiccups: for those caused by organic lesions, such as encephalitis, brain tumors, peritoneal lesions, pleural lesions, etc., patients will have diaphragmatic spasms lasting for more than 48 hours. If the above symptoms occur, you should seek medical advice and follow the doctor’s instructions for treatment.