Burping: Indigestion or Heart Attack?

  • 1st Revision: Adel

What is burping?

Burping, or belching, is the body’s mechanism to remove excess gas from the upper digestive tract.1

What is indigestion?

Dyspepsia, or indigestion, is a feeling of inadequate digestion which can be experienced in a myriad of ways including: belching, acid reflux, heartburn, bloating or inability to finish a normal meal.1 Can burping be a warning sign for a heart attack?

People experiencing a myocardial infarction (heart attack) may experience belching or indigestion symptoms.1 Belching has also been linked to symptoms of angina pectoris.2 

What is a heart attack?

Myocardial infarction occurs when the blood supply to a part of or the whole heart is suddenly blocked and therefore the heart muscle doesn’t receive sufficient oxygen to perform its function of pumping blood around the body.3 Myocardial infarction can result in the death of heart tissue and can be fatal.3 A heart attack can then lead to other complications such as heart failure because it can weaken the heart muscle and subsequently compromise its pumping  ability, sometimes described as heart failure.

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Obstruction of coronary arteries by blood clot causing a heart attack

Signs and symptoms of a heart attack include:4

  • Chest pain:
    •  Feeling pressure, tightness, or squeezing of the chest 
    •  May be severe in some cases but in others feel like indigestion
    • It spreads from the chest through your arms, jaw, neck and back
  • Lightheadedness or dizziness
  • Excessive sweating
  • Shortness of breath
  • Nausea and vomiting
  • Panic attack - overwhelming feeling of anxiety
  • Coughing or wheezing

Susceptibility to heart attacks  differences between men and women

Women are more likely to have symptoms like shortness of breath, nausea, vomiting and pain in the jaw and back. In both men and women the most common symptom is chest pain.4 

Causes and risk factors of a heart attack

The three key risk factors for heart attacks include:

  • High blood pressure
  • High blood cholesterol
  • Smoking

But there are many more risk factors including:

  • Age
  • Gender 
  • Lack of physical activity
  • Genetics
  • Stress
  • Obesity

A heart attack occurs when the blood flow to the heart is completely restricted, therefore meaning the arteries feeding the heart have become blocked. This may be because of a blood clot, this can happen if fatty deposits in the arteries become hardened and turn into a plaque which can then rupture and cause a blood clot to form in the artery, therefore blocking blood flow. 

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Risk Factors for a heart attack

Differential Diagnosis

Common differential diagnoses:

  • Chest pain 

What else could cause the symptoms?

 Symptoms experienced in a heart attack are common and could be a result of other conditions. 

For example, if the chest pain experienced during a heart attack is mild, or described as just discomfort rather than pain, it could be confused with indigestion, acid reflux or heartburn. 

It may also be linked to gas pain , which is a symptom of indigestion where there is a sharp pain in your stomach/ chest which goes away by burping or passing gas. 

Treatment for a heart attack

There are many different treatments for heart attacks depending on the causes of the myocardial infarction. 

Aspirin, clot busters (also known as thrombolytics), and blood-thinning drugs (like heparin) may be given in order to break up any blood clots obstructing the blood flow to the heart. 

If the  cause of obstruction of the blood flow to the heart was high blood pressure, anti-hypertensive medications may be prescribed. . 

Patients on unhealthy diet, and those who lack physical exercise/activity 

are likely to have high levels of cholesterol, so   the patient will be told to change their habits, have a healthier diet and may also be given statins (drugs that reduce bad  cholesterol).4

Coronary angioplasty can also be done. This consists of introducing a balloon into your body and guiding it to the blocked coronary artery where it is then  inflated to open up the artery.4 A coronary bypass graft can also be done instead of angioplasty. A blood vessel from another part of your body - like your leg - can be attached to your coronary artery in order to bypass the blockage, diverting blood around the blocked artery or arteries, thus improving the blood flow.4

Preventing heart problems

To prevent heart problems it is crucial to tackle the risk factors. Reduce blood pressure, reduce cholesterol blood levels, reduce stress, stop smoking and if there is a history of heart problems in your family make sure to follow healthy habits and get regular check ups at the doctor. 

To reduce blood pressure and cholesterol levels it is necessary to have a healthy diet, with a reduced alcohol consumption, and to do physical activity often.4

When to seek emergency medical help

Seek immediate medical attention and call for an ambulance if you are experiencing any of the heart attack symptoms, including chest pain that spreads from your chest towards your jaw, neck and arms and shortness of breath.4 

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Summary

Heart attack symptoms are relatively easy to spot. However, they  are also quite common and can often be mistaken for  other diseases like indigestion. If you are experiencing any of the symptoms of a heart attack, seek emergency medical help immediately. 

References

  1. Talley NJ, Phung N, Kalantar JS. Indigestion: When is it functional?. Bmj. 2001 Dec 1;323(7324):1294-7. Available at: British Medical Journal (nih.gov)
  2. El-Shafie K. Belching as a presenting symptom of angina pectoris. Sultan Qaboos University Medical Journal. 2007 Dec;7(3):257. Available at: December 2007 Vol 8 After Meeting.indd (nih.gov)
  3. Reed GW, Rossi JE, Cannon CP. Acute myocardial infarction. The Lancet. 2017 Jan 14;389(10065):197-210. Available at: Sci-Hub | | 10.1016/S0140-6736(16)30677-8 (hkvisa.net)
  4. https://www.nhs.uk/conditions/heart-attack/symptoms/
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Patricia Barnuevo

Bachelor's degree, Biotechnology with Industrial Experience, The University of Manchester, England

"I am accustomed to working in diverse and multicultural environments, and thrive on feeding my intellectual curiosity. "

Experienced in both a dynamic, corporate laboratory as part of the R&D team, and in academic laboratory projects.
She is also an experienced medical Writer.

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