Heart attack – or an attack of heartburn?

12 Jun

by Carolyn Thomas @HeartSisters

I was sent home from the Emergency Room with a misdiagnosis of indigestion (despite presenting with textbook heart attack symptoms like chest pain, sweating, nausea and pain radiating down my left arm) just two weeks before finally being hospitalized with a newly revised diagnosis of  ”significant heart disease”, and a myocardical infarction (heart attack) caused by a fully occluded Left Anterior Descending coronary artery.

Heartburn has nothing to do with your heart; it’s a digestive problem. Acidic liquid from your stomach backs up into your esophagus and inflames its lining. But symptoms can appear confusingly similar.

How to tell if you’re having a heart attack or just an attack of simple indigestion?

Here’s how indigestion may be markedly different from a cardiac event:

  • indigestion pain does not spread to other areas of the body like the arm, shoulder, upper back or jaw
  • indigestion pain is often relieved by taking antacid medications
  • indigestion can cause temporary chest pain when taking a deep breath or coughing (the intensity level of cardiac pain typically remains unchanged when you breathe deeply)
  • indigestion pain can continue for a few hours (cardiac pain can come and go over time)
  • with indigestion, you may notice a painful sensation in your chest that starts in your upper abdomen and radiates all the way to your neck
  • stomach acid that moves up into the esophagus during indigestion may leave a sour taste in your mouth — especially when you’re lying down
  • indigestion pain often responds to sitting up or standing (cardiac chest pain continues to hurt regardless of the position of your body)
  • indigestion can make you feel full
  • about half of pregnant women suffer bouts of indigestion
  • obese women are six times more likely to have indigestion
  • smoking can make indigestion symptoms worse
  • certain foods can trigger indigestion, such as chocolate, peppermint, fried or spicy foods, sugar, caffeine, alcohol, wheat products, or acidic fruits and veggies
  • both prescription and over-the-counter medications can also trigger indigestion, such as aspirin, ibuprofen, naproxen sodium (Aleve), prednisone, iron, or potassium
  • indigestion usually hits shortly after a meal or in the middle of the night, while heart attack symptoms can appear after exertion or even at rest
  • lying down or bending over generally makes indigestion symptoms worse
  • indigestion symptoms don’t include sweating or shortness of breath
  • both indigestion and a heart attack can cause a feeling of pressure and a gnawing or burning sensation in the chest

Frequent, persistent heartburn symptoms may indicate a more serious condition called acid reflux or gastroesophageal reflux disease (GERD) — the chronic regurgitation of acid from your stomach into your lower esophagus.

Remember that indigestion or heartburn isn’t the only digestive symptom that can include chest pain. A muscle spasm in your esophagus may have the same effect. The pain of a gallbladder attack also can spread to your chest. You may notice nausea and an intense, steady ache in the upper middle or upper right abdomen — especially after a fatty meal. The pain may also shift to your shoulders, neck or arms. 

The important thing to remember is that something is causing these distressing symptoms – you need to be your own best health advocate in order to help your doctor find out what the cause is.

Occasional bouts of heartburn are common. If you have persistent heartburn or take antacids daily, consult your doctor. Your heartburn may be a symptom of GERD or another condition.

If the heartburn seems worse or different than usual — especially if it occurs during physical activity or is accompanied by shortness of breath, sweating, dizziness, nausea or pain radiating into your shoulder and arm — get emergency help immediately. These signs and symptoms may indicate a heart attack.  Keep in mind that you can have both: people with indigestion can also have heart disease. 

In addition, seek medical attention immediately if you experience new chest discomfort and you have had a heart attack before, have heart disease or diabetes, smoke, are overweight, or have high cholesterol.

Don’t wait more than a few minutes to call 911 or emergency medical help. Proper diagnosis and prompt treatment may save your life.

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© 2009 Carolyn Thomas  www.myheartsisters.org

Reminder:  information on this site is not meant as a substitute for medical advice


♥    This article ranked as one of the Top 10 Most-Read Posts here on Heart Sisters (#3 on both 2012 and 2011 lists)   ♥  

23 Responses to “Heart attack – or an attack of heartburn?”

  1. Jennifer August 1, 2015 at 8:11 pm #

    I have just had my 3rd ER visit in the last month. I’m 42 years old and pretty healthy. I have what’s called Factor V Leiden, which basically means I clot more than the average Joe. I was diagnosed in the year 2000 after having multiple pulmonary emboli (lung blood clots) that put me in ICU for a week. I was then put on Coumadin “for life”. I took myself off Coumadin about 5 years later, because all of my INR/PT checks were good whether I took it or not, and frankly, the co-pays were killing me. That being said, here I am 10 years after not being on Coumadin and my first “heart or GERD” episode was about 2 months ago. It woke me in the middle of the night, in agonizing pain. It was my upper back that hurt, between my shoulder blades but mostly on the right. This was identical to the blood clot pain of 15 years ago. I know it sounds weird, even now doctors, and people in general are surprised; I had NO chest pain, NO shortness of breath, NO leg pain…ONLY severe, and I mean SEVERE back pain. That’s what this was like. I ignored it, was finally able to go back to sleep and woke up fine. It happened again about 3 weeks later while on vacation. I, again, was up for hours but was able to fall asleep again and woke up fine, then 2 weeks later but this time I had chest pain, too, mostly back but it radiated to my chest (upper chest) and I was also sweating and shaking, then that happened again a week later at which point I went to the ER. They EKG’d me right away, nothing wrong with my heart. My D Dimer levels were 52 when I got to the ER and 85 within an hour. D Dimer levels do not mean you have a blood clot but mean you should be checked further. They gave me a shot of Lovenox (blood thinner) and within the next 2 hours my pain level went from 8 to probably 2 or maybe even 1. I’m allergic to IVP dye so I had to get a VQ scan. The scan showed no clots. This time I decided to go to a Dr. and get back on blood thinners, figuring this was a scare of a blood clot. This now happened last week again, but worse. My chest was in so much pain, my back was killing me, I was sweating and shaking. I’m thinking it’s just some freak thing happening to me so I was up all night but again by morning, I was fine. It happened the next night, and then a 3rd night in a row. I was up all night but still going to work, as I was fine in the morning except being tired. I went to the ER again. Another EKG showed my heart was fine, although they did give me 4 aspirin this time. My blood pressure was in the 180’s over in the 60s (I don’t remember). But by the time I was discharged, only 2 hours later, my BP was normal. The Dr. at the ER said I have GERD although there was no test to confirm it; it’s just what he told me. I have an appointment with another (new) Dr. in 2 days. Yes, I have a lot of heartburn, yes Ranatidine works. No, this pain was absolutely NOT heartburn, or even severe heartburn. I was under the impression that GERD doesn’t necessarily feel like heartburn but as I keep reading more and more on GERD vs. heart attack, my symptoms point more towards heart, not GERD. I don’t want to be on blood thinners if I don’t have to be so it bothers me that I am and probably don’t need to be. But it also bothers me, and bothers me more, that I don’t know what the heck is going on with me. I have no stress in my life, I have a perfect life, perfect family, job, husband, money, etc. I don’t worry about anything. I’m healthy, I eat right. I don’t get it. Hoping for some answers soon. Last night, my first night on Nexium (GERD medication) I didn’t have an “episode” but also it wasn’t really happening every night anyway. I’m scared to go to sleep, I’m scared to eat anything in fear if it is GERD it’ll upset it. NOW I’m worrying and stressing. UGH


    • Carolyn Thomas August 2, 2015 at 6:31 am #

      Hello Jennifer – I’m not a physician so can’t comment on your specific symptoms, but I am very glad to hear you have an appointment with a new doctor. Perhaps that will help solve the mystery. Something is causing these distressing symptoms and you need a full assessment to help sort it out, and that includes a full medication review.

      So much of medicine seems to be just figuring out what the problem is NOT. And we know that it is entirely possible to have both cardiac issues AND heartburn at the same time. There is nothing worse in life than not knowing what the heck is going on – and that has absolutely nothing to do with how “perfect” life might be. The reality is that sometimes we just don’t know the reasons that bad things are happening to us. Best of luck to you with your new doc.


  2. Brea Houston July 20, 2015 at 8:50 am #

    Today is day 4 of having a “cold” pressure between my shoulder blades and having light pressure in my chest area at the same time. It feels like gas but the feeling doesn’t go away even when I can successfully make myself burp. The pressure in both the back and across the chest lessens/increases without rhyme or reason regardless of whether I am sitting, lying down or washing the floor. It definitely has a “cold” feeling to it. There is NO arm, neck, jaw pain at all. Since last night I have become a little nauseous but not much. I am drinking tea and find that today all I want is fluids. I ate a few bites of scrambled egg this morning and then refrigerated it. Yesterday my appetite was normal. I came here hoping to find out if anyone else ever experienced cold pressure as part of their “heart attack experience” but haven’t found anything about it yet.


    • Carolyn Thomas July 21, 2015 at 6:21 am #

      Brea, I’m not familiar with ‘cold pressure’ being indicative of a heart attack (although that doesn’t mean anything – I’ve heard some pretty wild and atypical symptoms that aren’t listed in any medical textbook!) After four days, it sounds like your symptoms are easing up. May or may not be cardiac-related at all, but ask your doctor for an assessment.


  3. Samantha July 13, 2015 at 11:39 am #

    If I went to the Dr every time I had one of these symptoms (arm pain, back pain, neck pain, chest pain, etc) I would be in the emergency room almost daily. How are we supposed to really know? Scary.

    Liked by 1 person

    • Carolyn Thomas July 13, 2015 at 4:35 pm #

      Good question, Samantha. Nobody wants to be running to the ER for no reason, nor do we want to miss seeking help when it does turn out to be serious. The key seems to be in asking: “Is this particular symptom unusual for ME?” And as I wrote here: “…especially if symptoms occur during physical activity or are accompanied by shortness of breath, sweating, dizziness, nausea or pain radiating into your shoulder and arm…” it should be checked out.


  4. Alan Pho January 30, 2015 at 1:04 am #

    Hi Carolyn,

    I just want to thank you for your information about differentiating heart attacks from heart burn.

    Hope all is well with you.

    Thanks again,

    Liked by 1 person

  5. apoorva November 16, 2014 at 5:08 am #

    hello there..
    last Sunday night I got caught up by chest congestion I mean cough… there was whistling sound when I was breathing…also I was feeling some pressure on my chest and heaviness in my upper left portion including chest , left arm, left shoulder, upper left back, left side of neck….accompanied with severe weakness in that portion.. and suffocation and breathlessness while eating and even when i walked …now …today is seventh day….I’m almost cured from cough and that blockage…but that heaviness and weakness in that left portion …and breathlessness while having meal or walking….and tiredness is still there.
    also I very often suffer from acidity.. but I felt nothing related to acidity during this period.. I’m a 19 year old girl.
    please tell me what is this all…



    • Carolyn Thomas November 16, 2014 at 6:23 am #

      Apoorva, I’m not a physician so cannot comment on your specific case. Please see your doctor.


  6. diane July 29, 2014 at 8:25 pm #

    Last night I woke with a bad pain in my right upper arm. That followed with indigestion. About an hr later, I had diarrhea. I have beem nervous and anxious all day, wondering if it was a heart attack.


    • Carolyn Thomas July 29, 2014 at 9:52 pm #

      Hello Diane – I’m not a physician so cannot comment specifically on your situation. I can tell you however that generally speaking if these symptoms seem worse than usual or occur during physical activity or accompanied by shortness of breath, sweating, dizziness, nausea or pain radiating into your shoulder and arm — you should seek medical help if they continue to persist.


  7. Jean July 3, 2013 at 3:06 pm #

    Very informative article. The digestive problem can cause quite a few symptoms as you mentioned.

    I have started telling people to look at their stresses and the foods they eat. Some foods can cause quite a bit of indigestion under certain conditions.

    Liked by 1 person

  8. Lee Hale March 6, 2013 at 6:04 am #

    I think it is important to know if you have any risk factors that might predispose you to a heart attack. It’s also best to err on the side of caution and overreact instead of underreact.

    Liked by 1 person

  9. AAR May 29, 2012 at 3:19 pm #

    Impressive! I have just forwarded this onto a coworker who was doing a little research on indigestion. And he in fact bought me breakfast due to the fact that I stumbled upon it for him… lol. So let me reword this…. Thank YOU for the meal!!


  10. Joyce March 26, 2012 at 9:09 pm #

    Thank you Carolyn for sharing this on heartburn symptoms; keep us posted with more relevant articles.


    • Carolyn Thomas March 27, 2012 at 5:20 am #

      Thanks for your comment, Joyce.


  11. Diane April 2, 2010 at 9:44 am #

    Wonderful website for women! Thankyou!

    I checked myself into an ER about 2 years ago w/chest pain. The pain across my back was excruciating and there was some heaviness in my chest. My cardiac enzymes were elevated, my EKG was so weird the ER doc called 5 cardiologists. I was hypotensive, tachycardic and could feel the fluids filling up in my lungs.

    I was flown to Albuequerque, NM where they did a heart cath and diagnosed w/Tako Tsubos. It’s a stress related cardiomyopathy. There’s a very informative website @ http://www.takotsubo.com. This is a rare condition, caused by stress. I’m 56 now, have been a registered nurse for 14 years.

    Keep up the informative work w/your website.

    Liked by 1 person

    • Carolyn Thomas April 3, 2010 at 12:09 pm #

      Thanks so much for your comments, Diane! I’d never even heard of Takotsubo or ‘broken heart syndrome‘ until I went to Mayo Clinic.

      I hope you are feeling much better now!



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