Heart Attack vs. Heartburn: How to Tell the Difference

Heart disease is the leading cause of death for both women and men in the United States, so if you’re having chest pain, it’s not unreasonable to be concerned. Fortunately, many episodes of chest pain aren’t related to the heart at all — instead, they’re caused by heartburn, a common issue involving your digestive system.

Knowing the differences between a heart attack and an episode of heartburn can play a critical role in ensuring you get life-saving care when you need it. In this post, experienced cardiologist Mikhail Kapchits, MD, and the team at Advanced Medical Care offer a few tips to help you make an informed decision about your health.

Heartburn basics

Most people have experienced heartburn at least once, often after a particularly spicy meal or from eating a heavy meal too close to bedtime. Heartburn happens when stomach acid backs up (or refluxes) into the esophagus, causing a burning sensation in the chest. 

Anyone can have heartburn, but it tends to happen more often among people who:

• Are overweight or obese
• Are pregnant
• Smoke
• Consume a lot of alcohol
• Eat a lot of fatty foods
• Take medications associated with stomach irritation

Even illnesses or mood disorders, like depression or anxiety, can increase your risk of heartburn and its symptoms.

People who have frequent or chronic heartburn may have a condition called gastroesophageal reflux disease (GERD). This condition happens when the valve at the end of your esophagus weakens, allowing acids to flow backward into the esophagus on a regular basis. People with GERD typically use medication to manage their symptoms and reduce the risk of complications.

Heart attack basics

A heart attack happens when blood flow to the heart is blocked. Most heart attacks are caused by coronary artery disease (CAD), the most common type of heart disease, responsible for nearly 400,000 deaths annually in the United States. 

CAD happens when your arteries become blocked by a buildup of sticky plaque and other substances. These blockages narrow your arteries and make them stiffer, interfering with normal blood flow. Sometimes, a blockage becomes so large that it stops the flow of blood to your heart.

Less often, a heart attack happens when blood flow is blocked for other reasons, like trauma or blood vessel contractions that temporarily limit circulation to the heart muscle. Heart attack risk is higher among people with:

• High blood pressure
• High cholesterol
• Smoking
• Obesity
• Sedentary lifestyle
• Alcohol abuse
• Older age
• Family history of heart attack or heart disease

People with certain diseases and medical conditions, such as diabetes or depression, have a higher risk, too.

Similar symptoms in your chest: Telling the difference

Because the heart and the end of the esophagus are located near each other, both heartburn and heart attacks can cause significant, sharp chest pain that’s difficult to distinguish. Still, there are a few factors that can help you determine what you’re experiencing.

Heartburn usually produces a burning pain that rises up from the stomach toward the throat. You might also notice a sour taste in your mouth or feel food or acid coming back up. These symptoms often worsen when you bend over, lie down, or eat a large meal.

A heart attack often causes pressure, squeezing, or fullness in the center or left side of the chest, and the discomfort may spread to the arm, neck, jaw, or back. Heart attacks often occur alongside other symptoms, such as shortness of breath, dizziness, sweating, nausea, or irregular heartbeat. Many heart attacks happen during or after physical exertion or periods of extreme stress.

Heartburn symptoms may lessen or go away completely shortly after taking an antacid or simply by changing position — like sitting up if you were lying down. A heart attack is generally unaffected by antacids and position changes.

When to seek help

Bottom line: Because both heartburn and heart attacks can cause pain in your chest, if you feel you might be having a heart attack, it’s always better to err on the side of caution and call 9-1-1. Even if it turns out to be heartburn, you won’t regret being cautious: GERD causes serious problems, too, including increasing your risk of esophageal cancer.

While you may not be able to completely prevent a heart attack, having a cardiac evaluation can help you understand your risks, especially if you have any of the risk factors listed above. To schedule your evaluation or to learn what else you can do to project your heart as you age, request an appointment online or over the phone with the team at Advanced Medical Care in Forest Hills, Queens, and Brighton Beach, Brooklyn, New York.