Heart attack – or an attack of heartburn?

~ Carolyn Thomas

by Carolyn Thomas  ♥ @HeartSisters

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:

See also:

© Carolyn Thomas  www.myheartsisters.org

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

♥    This article ranks as one of the Top 10 Most-Read Posts here on Heart Sisters
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Published by Carolyn Thomas

31 thoughts on “Heart attack – or an attack of heartburn?”

  1. I had a heart attack. I had heartburn all day and kept taking antacids. Then my throat hurt very badly. My chest had been hurting. But about 12:00 am my chest hurt SO bad. I got up and put ice on my chest. I had started a new medicine and thought I was having esophageal cramps. When I could no longer take the pain in my chest I went to the ER. Heart attack. I had a stent put in. And have been extremely tired ever since.

    Liked by 1 person

    1. You have been through quite a shocking event. Your delay in seeking treatment (instead believing your symptoms were due to heartburn or esophageal cramps) is remarkably common even in mid-heart attack. I did the same thing, until symptoms became unbearable. You didn’t mention when your heart attack occurred; if it was fairly recently, it’s not unusual to experience extreme fatigue as you recuperate both physically and emotionally. Here’s more about that. Best of luck to you…

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  2. That’s right I had popcorn and a big sugar filled soda at the Movies. Must be the soda.

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  3. It doesn’t help that I’ve been holding my phone for five hours working on stuff and the heartburn hits! So my left sholderish area under the collarbone decided to hurt at just that moment. Scary! I’m staying up for a while longer just in case. Took two Tums. Ni mir es heartburn. Stay calm and don’t panic. This site helped a lot, thank you.

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  4. 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

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    1. 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.

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  5. 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.

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    1. 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.

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  6. 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 2 people

    1. 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.

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  8. 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,
    Alan

    Liked by 2 people

  9. 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…

    thankyou

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  10. 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.

    Liked by 1 person

    1. 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.

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  13. 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.

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  14. 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

  15. 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!!

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

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  17. 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.

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