Heartburn or Heart Attack: Can YOU Tell the Difference?

Finally… all those months of strategic planning, tough negotiations, and extreme stress have paid off – you’ve made the biggest deal of your life. The big, celebratory dinner is the first time in months you’ve allowed yourself to relax. Now you’re back home, ready for bed, and thinking about that holiday you have been putting off. But… what is this excruciating chest pain? Heartburn? A heart attack? Something else?

Each year, over five million adults in America go to the hospital emergency room with chest pain. While many of them are indeed having a heart attack or the chest pain that often precedes one, some may be experiencing nothing more than severe heartburn.

Sometimes, it can be so difficult to distinguish between the chest pain that occurs during a heart attack and a bout of severe heartburn, that only sophisticated equipment can determine the cause of the chest pain. To make matters worse, not only are some heart attack and heartburn symptoms similar, but the two conditions have many risk factors in common. Both are more likely to occur in people 40 and older.

Your chest pain could signal a heart attack or something else, like heartburn. Knowing the difference between heartburn symptoms and heart attack symptoms is important and in some cases can be a life saver.

Heartburn Causes and Symptoms

A recent Gallup poll suggests that over 41% of adult Americans suffer from heartburn symptoms in any given month. In fact, the term "heartburn" does not actually have anything to do with the heart. Heartburn symptoms occur when stomach acid moves from the stomach into the esophagus. A ring of muscles called the lower esophageal sphincter (LES) normally prevents stomach acid from moving into the esophagus. When these muscles relax or weaken, stomach acid moves up and irritates the esophagus, causing one or more heartburn symptoms.


What causes the LES muscles to relax? The following activities or conditions are most likely to cause heartburn symptoms, either by relaxing the LES muscles or by increasing the production of acid in the stomach:

  • Overeating
  • Lying down immediately after eating
  • Consuming excessive amounts of alcohol
  • Smoking or using other tobacco products
  • Drinking caffeine-rich beverages such as coffee, tea, or soda
  • Eating foods that are spicy, high in fat content, or acidic (like tomatoes and citrus fruits)
  • High stress levels
  • Being overweight
  • Pregnancy

Typical signals of a bout of heartburn include:

  • Burning sensation in the chest, just behind the breastbone. This chest pain usually occurs soon after eating and may last from a few minutes to several hours.
  • Chest pain after lying down, eating, or bending over.
  • Burning sensation or feeling a hot, sour, salty, or acidic fluid in the throat.
  • Difficulty in swallowing.
  • A feeling that small amounts of food or liquid are coming back up the throat.
  • Chronic heartburn may cause hoarseness, sore throat, or cough.
  • During heartburn, chest pain does not usually spread to shoulders, neck, or arms, but it can.
  • Heartburn usually responds quickly to antacids or other heartburn treatments.

Heart Attack Risk Factors and Symptoms

A heart attack occurs when the blood supply to part of the heart is reduced or blocked entirely. This can result in death or disability, depending on how much of the heart muscle is damaged as a result of the blockage. Sadly, many people are not even aware that they are having a heart attack.


Mistaking a heart attack for heartburn can be extremely dangerous. Annually, over 1.1 million Americans experience heart attacks. Knowing when you might be having a heart attack and being able to distinguish a heart attack from heartburn symptoms is critical, particularly for people who are most at risk for heart disease.

Some risk factors for heart attack include:

  • High blood pressure
  • Diabetes
  • High cholesterol
  • Sedentary lifestyle
  • Being overweight
  • Smoking
  • Poorly controlled stress and anger
  • Family history of heart disease

A heart attack does not always happen suddenly. Many people experience warning signs for hours or even days before the actual heart attack. Common signals of a heart attack include:

  • Chest pain or discomfort that feels like a belt being tightened around the chest
  • Sudden pressure, tightening, squeezing or crushing chest pain that remains longer than a few minutes
  • Pressure or tightness in the chest during physical activity or under emotional stress
  • Shooting pain that extends to the back, neck, jaw, shoulders or arms (especially the left arm)
  • Dizziness or lightheadedness
  • Shortness of breath
  • Cold sweat or chills

When should I get medical help?

Chest pain is one of the most common reasons for emergency room visits. While occasional episodes of heartburn are common among adults, chronic heartburn may be a symptom of some other serious condition such as GERD (Gastroesophageal Reflux Disease). Talk to your doctor if you have chronic heartburn or if you are taking antacids every day.

If you have severe, crushing chest pain which lasts longer than a few minutes and does not disappear with an antacid, call 911 and seek immediate medical help. Do not be alone or isolate yourself from other people and do not try to drive yourself to the hospital. If you have any risk factor that may predispose you to a heart attack, be particularly cautious.

If you are having chest pain and suspect it may be a heart attack, seek emergency medical attention. It may turn out that you’re only having heartburn symptoms, since heart attack and heartburn symptoms can be hard to tell apart. However, this is one situation where it is better to be safe than sorry.

For more articles about heartburn symptoms and treatment options, consult the online knowledge base at eDrugstore.com.

Nexium is a product often prescribed to prevent heartburn. Learn more on the Nexium product information page.

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