Because heartburn (acid reflux) can cause chest pain, knowing the difference between heartburn and a heart attack can be challenging. A heart attack (myocardial infarction) is a medical emergency that occurs when blood flow to the heart muscle is reduced or blocked.
One of the symptoms of a heart attack is chest pain, but this doesn't always mean that someone clutches at their chest in pain like in the movies. Seek emergency care immediately for chest pain that comes on suddenly or that occurs along with nausea and/or pain in the shoulders.
This article will explain the differences between a heart attack and heartburn and when chest pain or other symptoms are a reason to go to the nearest emergency room.
Emergency Signs of a Heart Attack
People who are experiencing the following symptoms of a heart attack should call 911 or go to the closest emergency room:
- Chest pain or discomfort (pressure, squeezing, or fullness in the center of the chest that lasts more than a few minutes)
- Dizziness or lightheadedness
- Nausea
- Pain radiating into the arms (one or both), back, neck, jaw, or belly
- Shortness of breath
- Sweating/breaking out in a cold sweat
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Heartburn vs. Heart Attack Symptoms
The symptoms of heartburn and a heart attack have some overlap. Telling the difference between them can be difficult, but it is important because a heart attack will need emergency medical attention. If there's any concern that symptoms may be from a heart attack and not from heartburn, seek care at an emergency room immediately.
Symptoms of a heart attack may happen suddenly, but that's not always the case. There could be early warning signs. One of these early signs is angina, which is when the blood flow to the heart decreases temporarily. Angina causes chest pain and pressure, which may happen repeatedly.
People may have one or more of several symptoms when they are having a heart attack. The symptoms of a heart attack can include.
- Pain in the center or left side of the chest, which may feel like aching, pressure, squeezing, or tightness (the most common symptom)
- Breaking out in a cold sweat
- Fatigue (more common in women)
- Heartburn or indigestion
- Lightheadedness or sudden dizziness
- Nausea
- Pain or discomfort spreading beyond the chest and into the arm, back, jaw, neck, shoulder, or teeth
- Pain in the upper abdomen (belly)
- Rapid or irregular heartbeat
- Shortness of breath (more common in older adults)
- Vomiting
Acid reflux can also cause symptoms of:
- Chest pain
- Chronic cough
- Heartburn (a painful, burning sensation in the chest)
- Hoarseness
- Nausea
- Problems with swallowing or pain when swallowing
- Regurgitating stomach contents up and into the throat or mouth
Heart Attack vs. Acid Reflux Symptoms in Females
Heart disease is the leading cause of death in women in the United States. However, women might not be recognizing the symptoms and instead think that the signs are from acid reflux. Females can experience symptoms of a heart attack that are different from those of males.
The most common symptom of a heart attack in women is chest pain. Heart attack pain in women may feel sharp and be located in the neck, arm, or back. Women may also be more likely to experience fatigue, shortness of breath, nausea and/or vomiting, and pain in the back or the jaw.
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
Why Do Heart Attacks and Heartburn Happen?
The causes of heart attacks and causes of heartburn are different. However, some risk factors overlap.
Heart Attacks
A major cause of heart attacks is plaque buildup (atherosclerosis), which narrows or blocks the arteries, preventing them from bringing enough blood to the heart. Coronary artery disease is when these blockages affect the arteries that bring blood to the heart muscle.
Other reasons for heart attacks are:
- Myocardial infarction in the absence of obstructive coronary artery disease
- Spasms in the coronary artery, which could be related to smoking cigarettes or drug use
- Blood clots in the coronary artery (coronary artery embolism)
- A tear in the coronary artery (spontaneous coronary artery dissection)
Silent Heart Attack
When there are few symptoms of a heart attack, they are mild, or they aren't understood or diagnosed, this is known as a silent heart attack. Unfortunately, a delayed diagnosis can result in less positive outcomes. Take chest pain seriously, seek care, and advocate for yourself when something doesn't seem right.
Heartburn
Heartburn happens when the group of muscles at the lower end of the esophagus (the food tube), called the lower esophageal sphincter, becomes weakened. This may result in the stomach contents coming back up into the esophagus, called gastroesophageal reflux (GER), which can cause heartburn.
It can happen once in a while or become severe and/or chronic (long-lasting), when it might be gastroesophageal reflux disease (GERD).
Some of the risk factors for heartburn and/or GERD include:
- Having a hiatal hernia (a weak spot in the diaphragm)
- Being overweight or obese
- Pregnancy
- Smoking cigarettes
- Medications, which include benzodiazepines, calcium channel blockers, nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants
Heartburn vs. Heart Attack: How to Tell the Difference
The symptoms of heartburn and a heart attack can be similar. Chest pain, in particular, can be sudden and severe. It can help to remember that heartburn is related to digestion and not to the heart.
What Makes Your Symptoms Better?
Taking medicines that target heartburn or indigestion may improve symptoms. Over-the-counter (OTC) antacids and prescription or OTC acid-reducing medications may help.
Heartburn can also come on or feel worse when lying flat or bending over. Sitting upright or standing may help to prevent heartburn after eating or make the discomfort feel better.
Drinking Water
Drinking water or other fluids or eating foods that contain a lot of water may dilute the stomach acid that contributes to acid reflux or heartburn. Some choices for food or drink that may have this effect include water infused with cucumbers, lemon juice, or honey; herbal teas (without caffeine or additives); watermelon; cucumbers; and celery.
When Did You Last Eat?
Heartburn could come on after eating a large meal or one that is extremely spicy. If the symptoms start after eating a lot of food or spicy food, they could be related to heartburn.
Does the Pain Radiate?
The location of pain can also help you understand what may be causing it. Pain that radiates beyond the chest and into the arm, shoulders, neck, back, or jaw is a symptom of a heart attack. Heartburn pain can be felt in the chest and the throat but does not usually radiate to other parts of the upper body.
Are You Short of Breath or Sweating?
Symptoms of a heart attack include being short of breath and sweating or having clammy skin. These don't happen to everyone, but they are possible signs. People experiencing heartburn don't experience these symptoms as part of that condition.
Are You Bloated or Belching?
Abdominal bloating and belching (burping) can come on after eating a large meal or one that is heavily spiced or fatty. These symptoms can be related to chronic acid reflux. They are not commonly listed as symptoms of a heart attack.
Other Potential Causes of Chest Pain
Potentially confusing the difference between heartburn and a heart attack further: There are many other potential causes of chest pain. Sometimes, what is causing the pain may be clear, especially if it has happened before. But if there is any question about chest pain, call 911 or seek attention at an emergency room.
Some of the other causes of chest pain can include:
- Collapsed lung (pneumothorax)
- Feelings of anxiety
- Gastroesophageal reflux disease (GERD)
- Inflammation in the lungs (pleurisy)
- Muscle spasm or strain
- Myocarditis (inflammation of the heart)
- Pericarditis (inflammation of the sac around the heart)
- Pneumonia (lung inflammation, often due to an infection)
- Pulmonary embolism (blood clot in the lung)
How to Relieve Heartburn At Home
There are many potential ways to ease the burning and pain from heartburn with home remedies or over-the-counter medicines. These can include:
- Avoiding foods that trigger heartburn in some people, such as spicy, fatty, or greasy foods; alcohol; peppermint; caffeine; chocolate; citrus fruits and juices; tomatoes; chili peppers; black pepper
- Antacids, over-the-counter medications that neutralize stomach acid
- H2-receptor antagonists, over-the-counter and prescription medications that reduce stomach acid
- Proton pump inhibitors, over-the-counter and prescription medications that block the production of stomach acid
- Sitting upright after meals and going to bed several hours after eating the last meal of the day
- Sleeping with the head of the bed elevated
- Eating a food that may be a natural antacid such as aloe vera juice, baking soda, chamomile or turmeric tea, ginger, or deglycyrrhizinated licorice
How Heart Attacks Are Treated
Heart attacks may be treated in different ways. All of these treatments take place in a hospital with the help of a healthcare team. A heart attack is an emergency that needs immediate treatment.
Percutaneous Coronary Intervention
Percutaneous coronary intervention (PCI), also called coronary angioplasty, can restore blood flow to the heart. A catheter is inserted into the artery and moved through it using a live X-ray. PCI may open blockages in the artery caused by plaque.
Stenting
A stent is a small mesh tube. It might be placed inside an artery that has narrowed or has a weak section to hold it open.
Coronary Artery Bypass Grafting
Coronary artery bypass grafting (CABG) surgery (also called a bypass) might treat a severe heart attack when arteries are blocked. Or, it might prevent a heart attack if the arteries are blocked. In this surgery, healthy blood vessels replace the blocked artery to improve blood flow to the heart.
Heart-Healthy Lifestyle
Prevention is another big part of treating heart disease. People who have had a heart attack may be at risk for another. For that reason, changing diet and lifestyle could be recommended to avoid another incident or complications.
When to Contact Emergency Services
Call 911 or go to an emergency room if you're experiencing the symptoms of a heart attack. The symptoms don't always come on suddenly; they could start slowly. Don't wait to get care if you think that these symptoms could be from a heart attack.
Some people may worry about going to the emergency department for symptoms that don't turn out to be from a heart attack. But it is always better to get checked out for worrying symptoms.
Symptoms that are a reason to get healthcare right away include:
- Chest pain or discomfort, the most common symptom, may feel like pressure, squeezing, or fullness in the center of the chest that lasts more than a few minutes
- Dizziness or lightheadedness
- Nausea
- Radiating pain in the arms (one or both), back, neck, jaw, or belly
- Shortness of breath
- Sweating/breaking out in a cold sweat or feeling clammy
Summary
Chest pain is the most common symptom of a heart attack. It can be difficult to distinguish what is causing the pain and if it could be from a less serious cause such as heartburn, indigestion, or GERD.
Symptoms of a heart attack and heartburn have differences, but not every person who is experiencing either of these conditions has the same types of symptoms. The signs and symptoms of a heart attack in women might be different than they are in men.
People who are having chest pain or other symptoms of a heart attack should seek emergency care.
