Is It Heartburn or a Heart Attack?
The pain experienced during a heart attack and during a severe heartburn episode can be difficult to distinguish.
It is not unusual for people to mistake symptoms of heart disease (such as angina and even a
heart attack) for heartburn. Similarly, many people go to the emergency room each year out of fear that they are having a heart attack, only to find out they have severe heartburn. In fact, it often takes medical testing to make the determination.
Pain May Be Difficult to Distinguish
- A sharp, burning sensation below the breastbone or ribs
- Burning sensation may move up toward the throat
- Pain often occurs after eating, particularly when lying down
- Pain that increases when bending over, lying down, exercising, or lifting heavy objects
- Bitter or sour taste at the back of the throat
- Symptoms tend to respond quickly to antacids
- A feeling of uncomfortable fullness, pressure, squeezing, tightness, or pain in the center of the chest that lasts for more than a few minutes or goes away and comes back
- Often brought on by physical exertion or emotional stress
- Pain or discomfort that spreads to one or both arms, the back, stomach, neck, or jaw
- Shortness of breath
-
Other symptoms such as:
- Breaking out in a cold sweat
- Nausea
- Lightheadedness
- Fainting
- Palpitations (feeling a rapid heart beat)
Other Causes of Chest Pain
-
Other heart conditions, such as:
- Pericarditis—inflammation of the sac surrounding the heart
- Aortic dissection—rare, but dangerous condition in which the inner layers of the aorta separate
- Coronary spasm—arteries supplying blood to the heart go into spasm, temporarily limiting blood flow to the heart muscle
- Panic attack—periods of intense fear accompanied by anxiety, chest tightness, rapid heartbeat, rapid breathing, profuse sweating, and shortness of breath
- Pleurisy—inflammation of the lining of the chest and lungs, which causes chest pain that increases with coughing, inhalation, or deep breathing
- Costochondritis—inflammation of the rib cage cartilage
- Pulmonary embolism—a blood clot lodged in the artery of the lung
-
Other lung conditions, such as
- Collapsed lung
- Severe asthma
- Pneumonia
- Muscle-related chest pain—often accompanies fibromyalgia and other chronic pain syndromes
- Injured ribs, pinched nerves—can cause localized chest pain
- Shingles—infection of a nerve root, caused by reactivation of the chickenpox virus
- Gallbladder or pancreas problems—gallstones or inflammation of the gallbladder or pancreas can cause abdominal pain, which can radiate to the chest
- Disorders of the esophagus—swallowing disorders such as esophageal spasms and achalasia (failure of esophageal muscle to relax)
- Cancer—cancer involving the chest or that has spread from another part of the body
Seeking Medical Attention for Chest Pain
RESOURCES
The American College of Gastroenterology http://www.acg.gi.org/
American Heart Association http://www.heart.org/
CANADIAN RESOURCES
Canadian Cardiovascular Society http://www.ccs.ca/
Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/
References
Gastroesophageal reflux disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 12, 2012. Accessed July 14, 2012.
Heart attack. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/Heart-Attack%5FUCM%5F001092%5FSubHomePage.jsp. Accessed July 14, 2012.
Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/. Updated April 30, 2012. Accessed July 14, 2012.
ST-elevation myocardial infarction (STEMI). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 7, 2012. Accessed July 14, 2012.
Revision Information
- Reviewer: Brian P. Randall, MD
- Review Date: 07/2012 -
- Update Date: 07/14/2012 -