Chest discomfort is common, and sensations can be unsettling, leading to concerns about serious health events. Many individuals wonder if heartburn-like symptoms indicate a heart attack. While distinct, heartburn and heart attack symptoms can overlap, causing confusion. Understanding their differences is important for recognizing when medical attention is necessary. This article clarifies these distinctions and guides appropriate actions.
What is Heartburn
Heartburn is a burning sensation in the chest, typically behind the breastbone. It is caused by stomach acid flowing back into the esophagus, the tube connecting the mouth to the stomach. This backward flow of stomach acid is known as acid reflux. The esophagus lining cannot withstand stomach acid, leading to irritation and discomfort.
The lower esophageal sphincter (LES), a muscle between the esophagus and stomach, normally acts as a valve, closing to prevent acid reflux. Heartburn occurs when this muscle weakens or relaxes, allowing stomach acid to leak upwards. Factors contributing to heartburn include consuming coffee, tomatoes, alcohol, chocolate, spicy, or fatty foods. Eating large meals, lying down too soon after eating, being overweight, stress, and anxiety can also trigger symptoms. Some medications, like anti-inflammatory painkillers, may also play a role.
Heartburn symptoms typically involve a burning chest pain, often with a sour taste in the mouth. This discomfort intensifies after eating, especially large meals, and when lying down or bending over. Other symptoms include a cough, hoarse voice, bad breath, bloating, or feeling sick. Occasional heartburn is common, but frequent occurrences may indicate gastroesophageal reflux disease (GERD).
What is a Heart Attack
A heart attack occurs when blood flow to a part of the heart muscle is severely reduced or blocked. This blockage usually results from fatty, cholesterol deposits (plaque) in the coronary arteries. If plaque ruptures, a blood clot can form, obstructing the artery and depriving the heart muscle of oxygen. Without prompt blood flow restoration, the affected heart muscle can suffer permanent damage or die.
Classic heart attack symptoms include chest pain or discomfort, feeling like pressure, tightness, squeezing, or aching. This pain can last more than a few minutes or come and go. Discomfort may spread to other upper body areas, such as one or both arms (often the left), the back, neck, jaw, or stomach. Shortness of breath is another common symptom, often accompanying chest discomfort. Other signs include cold sweats, lightheadedness, dizziness, nausea, or vomiting.
Heart attack symptoms vary significantly; some individuals experience subtle or atypical signs. Women, older adults, and those with diabetes often present with less obvious symptoms, such as unusual fatigue, anxiety, or shortness of breath without chest pain. Older adults might exhibit confusion, weakness, or dizziness, with mild or no chest pain. People with diabetes may also have muted symptoms due to nerve damage, experiencing only mild discomfort or fatigue. A heart attack requires immediate medical attention.
How to Tell the Difference
Distinguishing between heartburn and a heart attack can be challenging due to overlapping chest discomfort. However, several factors help differentiate them. Heartburn typically presents as a burning sensation behind the breastbone, sometimes extending into the throat. This pain relates to the digestive system and feels like acid burning. In contrast, heart attack pain is often described as pressure, squeezing, fullness, or a heavy sensation in the chest, and can also feel like a crushing pain.
The timing and triggers of pain provide important clues. Heartburn commonly occurs after eating, especially large or fatty meals, and worsens when lying down or bending over. Specific foods or drinks may also trigger it. Heart attack pain, while possible after meals, is more often associated with physical exertion, emotional stress, or may arise without a clear trigger. Heart attack pain typically does not improve with antacids, unlike heartburn, which generally persists for a few minutes to several hours.
Pain location and radiation also differ. Heartburn pain tends to stay localized to the chest and throat, though it can feel like food is stuck. Heart attack pain frequently radiates to other upper body parts, including the arms (particularly the left), back, neck, jaw, or upper abdomen. Shortness of breath, cold sweats, nausea, and lightheadedness are common accompanying heart attack symptoms, less typical for isolated heartburn. While heartburn can cause nausea, these additional systemic symptoms strongly suggest a cardiac event.
When to Get Medical Help
Given the potential for overlapping symptoms, always err on the side of caution with chest pain or discomfort. Prompt medical evaluation is important, as delaying heart attack care can lead to permanent heart damage or be fatal. If chest pain is severe, sudden, or accompanied by other concerning symptoms, immediate medical attention is necessary.
Call emergency services for these warning signs:
Chest pain lasting more than a few minutes
Pain spreading to the arm, jaw, neck, or back
Pain feeling like squeezing or pressure
Shortness of breath
Cold sweats
Nausea or vomiting
Lightheadedness occurring with chest discomfort
Also seek emergency help if chest pain does not subside with rest or antacids, or if you feel overwhelming anxiety. Even if symptoms ultimately turn out to be heartburn, seeking prompt medical assessment when a heart attack is possible is the safest course of action.