I was sent home from the Emergency Room with a misdiagnosis of heartburn (despite presenting with textbook heart attack symptoms like chest pain, sweating, nausea and pain radiating down my left arm). This was just two weeks before finally being hospitalized with a newly revised diagnosis of “significant heart disease” and myocardial infarction (heart attack) caused by a fully occluded left anterior descending coronary artery – the so-called “widowmaker” heart attack.
Heartburn has nothing to do with your heart; it’s a digestive problem. Acidic liquid from your stomach can back up into your esophagus where it inflames the lining. But symptoms can appear confusingly similar.
How to tell if you’re having a heart attack or just an attack of simple heartburn?
Here’s how heartburn may be markedly different from a cardiac event:
- heartburn pain does not spread to other areas of the body like the arm, shoulder, upper back or jaw
- heartburn pain is often relieved by taking antacid medications
- lying down or bending over generally makes heartburn symptoms worse
- heartburn 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)
- heartburn can continue for a few hours (cardiac pain can come and go over time)
- withheartburn, 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 heartburn may leave a sour taste in your mouth — especially when you’re lying down
- heartburn pain often responds to sitting up or standing (cardiac chest pain continues to hurt regardless of the position of your body)
- heartburn can make you feel full
- about half of pregnant women suffer bouts of heartburn
- obese women are six times more likely to have heartburn
- smoking can make heartburn symptoms worse
- certain foods can trigger heartburn, 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 heartburn, such as aspirin, ibuprofen, naproxen sodium (e.g. Aleve), prednisone, iron, or potassium
- heartburn 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
- heartburn symptoms don’t include sweating or shortness of breath
- both heartburn and a heart attack can cause a feeling of pressure, and a gnawing or burning sensation in the chest
Sources: Mayo Clinic, MedLine Plus, The College of Family Physicians of Canada
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 condition that can include chest pain. See also: What Is Causing My Chest Pain?
A muscle spasm in your esophagus may have the same effect. So can the inflammatory condition called costochondritis. 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, but 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 shoulders or arms — get emergency help immediately. These signs and symptoms may indicate a heart attack. Keep in mind that you can have both: people with heartburn can also have heart disease.
In addition, seek medical attention immediately if you experience new chest discomfort and you have had a heart attack previously, have heart disease or diabetes, smoke, are overweight, or have high cholesterol.
Don’t wait more than a few minutes to call 911 or seek emergency medical help. Proper diagnosis and prompt treatment may save your life.
Learn more about:
- When chest pain is “just” costochondritis
- Women Fatally Unaware of Heart Attack Symptoms
- Misdiagnosis in Women’s Heart Disease
- 85% of hospital admissions for chest pain are NOT heart attack
- What is causing my chest pain?
- The freakish nature of cardiac pain (first of a 3-part series on pain)
- Brain freeze, heart disease and pain self-management (second of a 3-part series on pain)
- Chest pain while running uphill (third of a 3-part series on pain)
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