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How can I tell the difference between heartburn and a heart attack?

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

You may not know if heartburn is a heart attack in disguise. People with heartburn can be having a heart attack, and people having a heart attack, may experience heartburn. Distinguishing between the two is difficult. Pay attention to when the attack occurs and how you feel. If you are getting it 30 to 45 minutes after a meal, it is probably heartburn. Heart attacks often occur with activity or exertion and many people have a feeling of impending doom when they are having a heart attack.

Symptoms of a heart attack include the following:

  • Sudden pressure, tightening, squeezing or crushing chest pain
  • Pain that radiates to the back, neck, jaw, shoulders or arms, particularly the left side
  • Shortness of breath, sweating, dizziness, nausea or stomach pain

Unfortunately, there is no perfect way to differentiate heartburn and a heart attack. Certainly, a response to an antacid marked by improvement in symptoms could suggest acid reflux/heartburn. Conversely, if nitroglycerin helps the discomfort, this could be a clue that symptoms may be cardiac in nature. Until this has been properly evaluated, it is impossible to know for sure, and patients should err on the side of caution and seek medical attention.

Symptoms of heart attack and severe heartburn can be difficult to differentiate. You've just eaten a big meal and feel a burning sensation in your chest. Heartburn, right? Probably, but there's a chance the chest pain is caused by reduced blood flow to your heart or an actual heart attack. A muscle spasm in the esophagus can also mimic chest pain. Gallbladder attack can also feel similar to heart attack, especially because of concurrent symptoms of nausea, vomiting and radiated pain to shoulders. The best plan is to seek medical attention and have heart attack ruled out.

Dr. Lawrence S. Friedman, MD
Gastroenterologist

Chest pain may mean a heart attack instead of heartburn. Symptoms associated with gastroesophageal reflux disease (GERD) can mimic the pain of a myocardial infarction (heart attack) or angina (chest pain caused by diminished blood flow through the coronary arteries), especially when the sensation is constricting rather than burning in nature. It can be dangerous to assume that your chest pain is caused by reflux. People with known reflux disease should always seek medical attention if they experience chest discomfort brought on by exercise, which may signal either angina or a heart attack.

How can you be sure that you have heartburn, not a heart attack? The main thing to determine is the severity and length of your chest pain. If it's a severe, pressing or squeezing discomfort, it may be a heart attack. And heart attack pain lasts awhile. If it goes away in 5 to 10 minutes, it's probably not a heart attack. It could be angina, however, which does require a visit to the doctor—and treatment. It's important not to dismiss chest tightness, especially if it follows physical exercise.

Dr. Chetan A. Patel, MD
Cardiologist (Heart Specialist)

It can sometimes be difficult to distinguish heartburn or indigestion pain from a heart attack. If you do not have a history of heartburn or the discomfort is worse or different than usual, you should be more concerned about a heart attack. There is no absolute way to tell the difference so if something does not feel right to you, it is better to be safe than sorry. If you are concerned the discomfort could be from a heart attack, you should seek immediate medical care in an Emergency Department or call 911. Never drive yourself to the emergency room if you think you might be having a heart attack.

The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.