Heartburn or Heart Attack? Don’t Dismiss Chest Pain

2/14/2018

By Ifeoluwa Okusanya, M.D., Cardiovascular Disease

When chest pain strikes, it’s sometimes hard to know if the cause is that burrito you ate for lunch – or a heart attack. Symptoms of heartburn and heart attack can be quite similar, but the right diagnosis can literally be a matter of life and death.

Heartburn and other digestive disorders do not generally constitute a health emergency, but sometimes, it’s hard to distinguish the type of chest pain you are experiencing. Because heartburn is so common, and over-the-counter remedies are plentiful, the first instinct when experiencing a twinge of chest pain is to self-medicate. However, health experts recommend always erring on the safe side, and making your doctor aware of pain – especially if it is a new symptom – before treating yourself at home.

What is heartburn?
Heartburn, also known as acid reflux, affects more than 60 million Americans. It can occur when the lower esophageal sphincter – a ring-shaped muscle that acts as a valve between the esophagus and the stomach – does not close properly, allowing stomach acid to back up into the esophagus.

Severe, chronic heartburn is called gastroesophageal reflux disease (GERD). The main symptom of GERD in adults is frequent, burning pain in the lower part of the chest, behind the breast bone, and in the abdomen. If a person regularly experiences heartburn more than twice a week, they are considered to have GERD, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

While the exact cause of GERD is unknown, research has shown that GERD happens when the lower esophageal sphincter relaxes, allowing the contents of the stomach to seep backward into the esophagus, but the rest of the esophagus continues to work normally. Factors known to contribute to heartburn and GERD include obesity, pregnancy, and smoking, as well as consuming spicy, fried or fatty foods; chocolate; citrus fruits; and caffeinated drinks.

Heartburn versus heart attack
Each year, approximately 300,000 new cases of non-cardiac chest pain are diagnosed in the United States, according to the Mayo Clinic. Studies show that between 22 and 66 percent of patients with non-cardiac chest pain are experiencing GERD. The difference in heartburn and heart attack symptoms is the frequency and timing of symptoms.

Heartburn/GERD:

• The chest pain usually occurs after eating, or while lying down.
• Pain may be accompanied by a sour taste in the mouth, due to stomach acid moving up into the esophagus.
• Pain may be brief, or may continue for several hours.
• Chest pain may be accompanied by dry cough, asthma symptoms, or trouble swallowing.

Heart attack:
Chest pain or discomfort involves uncomfortable pressure, squeezing, fullness, or pain in the center or left side of the chest that can be mild or strong. This discomfort or pain often lasts more than a few minutes or goes away and comes back. Other patterns include upper body discomfort in one or both arms, the back, neck, jaw, or upper part of the stomach.

• Shortness of breath, which may occur with or before chest discomfort.
• Nausea, vomiting, light-headedness or sudden dizziness, or breaking out in a cold sweat.
• Pressure or tightness in the chest during physical activity or when you're under emotional stress

If you regularly experience heartburn and the pain seems to worsen, or is different than usual – or if it occurs during physical activity and is accompanied by any of the above symptoms, call 911 or proceed to the nearest emergency room, immediately.

Learn more by calling (931) 685-8780 for an appointment.

About the Author:
Dr. Okusanya completed her internal medicine residency and cardiology fellowship at State University of New York Health Science Center in Brooklyn, N.Y. She also is skilled in clinical cardiology, ECGs, echocardiography, nuclear cardiology, cardiac CT angiography and diagnostic left and right heart catheterizations. She is currently accepting new patients at Tennova Cardiology, 2839 Hwy 231, North, Suite 208, Shelbyville, TN 37160.

Remember that this information is not intended to replace the advice of your doctor, but rather to increase awareness and help equip patients with information and facilitate conversations with your physician that will benefit your health.

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