The pain experienced during a heart attack and during a severe
episode can be difficult to distinguish.
It is not unusual for people to mistake symptoms of heart disease (such as
and even a
) 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.
Here are some possible differences between the heartburn and heart attacks.
Possible Signs of Heartburn A sharp, burning sensation below the breastbone or ribsBurning sensation may move up toward the throatPain often occurs after eating, particularly when lying downPain that increases when bending over, lying down, exercising, or lifting heavy objectsBitter or sour taste at the back of the throatSymptoms tend to respond quickly to antacids
Call for emergency medical services right away if you have any chest pain, even if you think it may be heartburn.
Possible Signs of Angina or Heart Attack 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 backOften brought on by physical exertion or emotional stressPain or discomfort that spreads to one or both arms, the back, stomach, neck, or jawShortness of breath
Other symptoms such as:
Breaking out in a cold sweatNauseaLightheadednessFaintingPalpitations (feeling a rapid heart beat)
Heartburn and heart attacks are not the only conditions that can cause chest pain. Other problems that can cause chest pain include:
Other heart conditions, such as:
Coronary spasm—arteries supplying blood to the heart go into spasm, temporarily limiting blood flow to the heart musclePericarditis
—inflammation of the sac surrounding the heart
Aortic dissection—rare, but dangerous condition in which the inner layers of the aorta separate
Panic attack—periods of intense fear accompanied by
, chest tightness, rapid heartbeat, rapid breathing, profuse sweating, and shortness of breath
—inflammation of the lining of the chest and lungs, which causes chest pain that increases with coughing, inhalation, or deep breathing
—inflammation of the rib cage cartilage
—a blood clot lodged in the artery of the lung
Other lung conditions, such as
Muscle-related chest pain—often accompanies
and other chronic pain syndromes
Injured ribs, pinched nerves—can cause localized chest painShingles
—infection of a nerve root, caused by reactivation of the
Gallbladder or pancreas problems—
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
(failure of esophageal muscle to relax)
—cancer involving the chest or that has spread from another part of the body
Chest pain can be difficult to interpret. Call for emergency medical services right away if you have any chest pain, especially if you have other signs and symptoms of a heart attack. Do not have someone drive you to the emergency room. Emergency medical crews can administer treatment on the way to the hospital.
Gastroesophageal reflux disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 22, 2014. Accessed June 11, 2014.
Heart attack. American Heart Association website. Available at:
Accessed June 11, 2014.
Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) in adults.
National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
Updated May 14, 2014. Accessed June 11, 2014.
ST-elevation myocardial infarction (STEMI). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 29, 2014. Accessed June 11, 2014.
Last reviewed June 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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