Chest discomfort or a burning sensation in the chest can often feel like heartburn, yet these symptoms can stem from various sources beyond typical acid reflux. Recognizing these sensations can be misleading is important for identifying the underlying cause.
What Heartburn Really Is
Heartburn, also known as acid indigestion, is a burning sensation in the chest, usually behind the breastbone. It occurs when stomach acid flows back into the esophagus, the tube connecting the mouth to the stomach. This backward flow is called acid reflux, and frequent occurrences are known as gastroesophageal reflux disease (GERD). Common triggers include certain foods, large meals, and lying down too soon after eating.
Esophageal Conditions Mimicking Heartburn
Several conditions affecting the esophagus can produce sensations similar to heartburn. Esophageal spasms involve abnormal contractions of the muscles in the esophagus, causing sudden, intense chest pain that might be mistaken for heartburn. This pain can be severe and may radiate to the back, neck, or arms.
Non-acid reflux occurs when non-acidic stomach contents, such as bile or gas, reflux into the esophagus, leading to chest discomfort or a burning sensation. Eosinophilic esophagitis, an allergic inflammatory condition, can also cause chest pain, difficulty swallowing, or food getting stuck. In this condition, eosinophils, a type of white blood cell, build up in the esophageal lining, leading to inflammation and discomfort.
Chest Pain From the Heart
Chest pain originating from the heart can be confused with heartburn. Angina, chest pain or discomfort caused by reduced blood flow to the heart muscle, can manifest as a squeezing, pressure, fullness, or pain in the center of the chest. This discomfort may spread to the shoulders, arms, neck, jaw, or back. Stable angina typically occurs with physical exertion or emotional stress and subsides with rest or medication, while unstable angina can occur at rest and is a medical emergency.
A heart attack, or myocardial infarction, presents with chest pain described as pressure, tightness, or a crushing sensation, which can radiate to the left arm, jaw, or back. Unlike heartburn, cardiac pain may be accompanied by shortness of breath, cold sweats, nausea, or lightheadedness. Persistent or severe chest pain, especially with these associated symptoms, warrants immediate medical attention.
Other Gastrointestinal Causes
Several other digestive conditions can also lead to symptoms that mimic heartburn. Gallstones, hardened deposits in the gallbladder, can cause sudden, intense pain in the upper right or center abdomen, often after eating fatty foods. This pain can radiate to the back or right shoulder and may be confused with heartburn.
Stomach ulcers, open sores on the stomach lining, cause a burning pain in the upper abdomen that may worsen between meals or at night. This discomfort can sometimes be perceived higher in the chest area, similar to heartburn. Gastritis, an inflammation of the stomach lining, can also present with a gnawing or burning ache in the upper abdomen, along with nausea, vomiting, or a feeling of fullness. Pancreatitis, an inflammation of the pancreas, often causes severe upper abdominal pain that can radiate to the back, which might be mistaken for heartburn due to its location.
Non-Digestive System Explanations and When to Seek Medical Help
Chest discomfort can also arise from sources outside the digestive system. Musculoskeletal issues, such as costochondritis, an inflammation of the cartilage connecting the ribs to the breastbone, can cause sharp, localized chest pain that worsens with movement or pressure. Muscle strains in the chest wall from physical activity can similarly produce pain that might be mistaken for an internal issue. Respiratory conditions like asthma can cause chest tightness, while pleurisy, an inflammation of the lung lining, leads to sharp chest pain, particularly with deep breaths.
Anxiety or panic attacks often manifest with chest pain, shortness of breath, and heart palpitations, which can be alarming and easily confused with cardiac or digestive issues. Nerve-related conditions, such as shingles, caused by the varicella-zoster virus, can result in a painful rash on one side of the body, including the chest, even before the rash appears. This nerve pain can be felt as a burning or tingling sensation.
When experiencing persistent or concerning heartburn-like symptoms, especially if they are new, severe, or accompanied by symptoms like shortness of breath, sweating, dizziness, or pain radiating to the arm or jaw, seeking immediate medical help is important. These symptoms may indicate a serious underlying condition.