Heartburn or Heart Problem?

Heartburn or Heart Problem?

Despite the name, heartburn has nothing to do with the heart. Heartburn occurs when stomach contents and acid creep up into the esophagus, whereas the usual cause of true heart pain—​such as due to a heart attack or angina—is a lack of blood in the arteries that feed the heart muscle. Totally different problems.

But telling them apart isn’t always so easy. Both conditions can cause similar chest pain, and often it takes medical tests to sort out the real problem. In fact, of the people who go to the hospital complaining of chest pain, it turns out that more than half don’t have a heart-related problem. Of those, 60 percent actually have heartburn.

The reason for the confusion: The nerves that sense pain in the heart and along the digestive tract simply aren’t that good at pinpointing the source and nature of the pain. Problems with the heart, stomach and even the gall bladder can register simply as “chest pain,” full stop. The symptoms are especially vague in women and older adults.

Worse, heartburn can even be a harbinger of a heart attack. Nearly 40 percent of women who had a heart attack said they experienced heartburn or indigestion shortly beforehand.

However, that’s not to say there aren’t any differences that can clue you in to the cause of your pain—and guide you on how to act. Here’s a quick cheat sheet of symptoms that tend to be more common with each condition.

Heartburn hints:

  • Burning pain
  • Occurs after eating, especially if the meal was large, fatty or spicy
  • May move up toward the throat
  • Worse when lying down or bending over
  • Acidic or bitter taste in your mouth
  • Usually relieved by antacids

Heart-related warning signs:

  • Pressure, tightness, squeezing or sense of fullness
  • Occurs after physical exertion or during times of stress
  • May spread to back, neck, jaw, shoulders or arms, particularly on the left side
  • Accompanied by shortness of breath, a cold sweat, dizziness or nausea

Be safe, not sorry
Remember, these aren’t hard-and-fast rules. Heartburn pain sometimes will radiate to the jaw, for example, and a large meal can redirect blood flow away from the heart, leading to angina. “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,” says Dr. Chetan Patel, a cardiologist with Greenville Health System in South Carolina. If your chest pain is more severe or feels different than usual—and especially if you’re a woman or the pain was brought on by exercise—call 911 or get emergency help without delay. Be extra cautious if you have risk factors for heart disease, such as diabetes, smoking, high cholesterol or excess weight.

Medically reviewed in December 2019.

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