How do you know if it is heartburn and not a heart attack?
Did you ever have a painful sensation in the center of your chest during a regular after-dinner walk around the house or backyard? It could be your heartburn flaring up again or it may be something more serious like a heart attack.
Heartburn and a heart attack may have similar manifestations on the chest and their symptoms may sometimes be difficult to differentiate.
Heartburn is a common symptom of gastroesophageal reflux disease (GERD), often called acid reflux. This makes acid from the stomach move up into the esophagus, causing a painful burning sensation just behind the breastbone. Not surprisingly, heart attack may also present with a discomfort in the same area. In the emergency room alone, heartburn accounts for nearly half the cases in which actual heart problems are ruled out according to a study by Mousavi et al. in 2007.
Chest pain caused by a heart attack results from reduced blood flow from the heart muscles and is often described as a feeling of tightness, constriction or pressure rather than a burning sensation. But it is not always easy to tell the difference.
The symptoms of heartburn may mimic those of a heart attack. Here are the common symptoms that differentiate heartburn from a heart attack:
- Burning chest pain that begins at the breastbone
- Pain that moves up toward the throat
- Pain or discomfort that does not typically radiate to the shoulders, neck or arms
- Sensation that food is coming back into the mouth
- Bitter or acidic taste at the back of the throat
- Pain that worsens when lying down or bending over
- The appearance of symptoms after a heavy or spicy meal
- Tightness, pressure, squeezing, stabbing or dull pain most often in the center of the chest
- Pain that spreads to the shoulders, neck or arms
- Irregular or rapid heartbeat
- Cold sweat or clammy skin
- Lightheadedness, weakness or dizziness
- Shortness of breath
- Nausea, indigestion and sometimes vomiting
- Symptoms are associated with physical exertion, extremes of emotions or stress
The treatment of the two conditions are entirely different. For heartburn, doctors may prescribe antacids and acid-suppressing drugs such as omeprazole and pantoprazole.
For symptoms of a possible heart attack, immediate consult at the emergency room is necessary for prompt management. If you have symptoms and you are not sure as to what they are associated with, seek emergency medical consult especially if you feel chest tightness, have trouble breathing, have cold clammy perspiration or cold sweat, have a feeling of light headedness and there is body weakness, sudden dizziness, fatigue, paleness and pain in your chest or arm that may extend to your neck or jaw.
Always consult a doctor who can best tell you if your symptoms are caused by heartburn or a heart attack.
Wang WH, Huang JQ, Zheng GF, Wong WM, Lam SK, Karlberg J, Xia HH, Fass R, Wong BC. Is proton pump inhibitor testing an effective approach to diagnose gastroesophageal reflux disease in patients with noncardiac chest pain?: a meta-analysis. Arch Intern Med. 2005 Jun 13;165(11):1222-8. doi: 10.1001/archinte.165.11.1222. PMID: 15956000.
Mousavi S, Tosi J, Eskandarian R, Zahmatkesh M. Role of clinical presentation in diagnosing reflux-related non-cardiac chest pain. J Gastroenterol Hepatol. 2007 Feb;22(2):218-21. doi: 10.1111/j.1440-1746.2006.04416.x. PMID: 17295874.