Difference Between Gas Pain and Heart Attack

What can cause “gas pain”?

Gas comprises odourless vapour, hydrogen gas, methane, nitrogen, oxygen and carbon dioxide. These gases are formed in the digestive system which can result in an unpleasant sulphur odour when it has mixed with bacteria in the intestine. Gases are either released through the mouth which is called belching or through the rectum which is called flatulence or commonly known as farting.^[3]

Sometimes can get built up and trapped in the stomach which results in gas pain or bloating. Gas pain is mainly caused by two sources

• Air swallowing (Aerophagia) - Air swallowing can be caused by eating or drinking rapidly, smoking, chewing guns and wearing loose dentures. Most swallowed air tends to leave the stomach through belching while a small amount is released through flatulence in the rectum. Some aerophagia can be short-term or long-term and are often related to physical and psychological factors.

• Breaking down of certain foods which are undigested by harmful bacteria in the large intestine can also cause gas pain. Foods like starch, fibre and sugar are not easily digested due to the absence of some enzymes, a lot of these foods pass through the large intestines where they are acted on by bacteria to be broken down which produces carbon dioxide, hydrogen and in one third of people, they produce methane gas which are release by flatulence.

What is heartburn?

According to the NHS, heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat (acid reflux). If it keeps happening, it is called gastro-oesophageal reflux disease (GORD). In the process of digestion where food, enzymes and acid are combined for the digestive process, the stomach is lined by protective cells which prevent the acid from causing inflammation. The oesophagus does not have these protective lining and in the case where the digestive juice and stomach acid reflux back into the oesophagus, it can cause damage to the unprotected lining.

Causes 

• Over the counter medications like caffeine, aspirin, acidic foods, carbonated beverages.
• Consumption of foods with high fats content
• Pregnancy
• Obesity
• Primary diseases in the oesophagus like scleroderma. 

Symptoms

Oftentimes, a sharp pain is often felt around the breast bone like a burning sensation which is often mistaken for heart attack. The pain felt from heartburn remains in the chest and later moves towards the back of the throat as well as a sour taste in the back of the throat. Coughing episodes and voice hoarseness can occur when the acid is towards the voice box as well a decay of teeth when the acid has prolonged over a long period of time as it goes towards the enamel of the teeth.¹³

Treatment

Lifestyle modifications can really enhance the treatment of heartburn. These changes include:

1. Smoking cessation 
2. Raising the head with some pillows to allow gravity to keep the acid in the stomach to avoid reflux
3. Avoid late night eating
4. Eating smaller and consistent meals

What is a heart attack?

A heart attack is said to occur when a part of the heart muscle does not get enough blood. If there is a shortage of blood rich in oxygen to the heart,² it can cause damage to the affected area of the heart, which can make an individual at risk of heart failure, most of the time, supply to the heart is usually blocked by a blood clot.¹²

Risk factors

Modifiable risk factors include; 

• Having a high blood pressure
• Having a high blood cholesterol 
• Smoking 

Non-modifiable risk factors include 

• Age 
• Having a family history of heart attack²

Signs and symptoms of a heart attack

• Coughing or wheezing
• Pain or discomfort in the neck, jaw
• Frequent chest pain or discomfort
• Shortness of breath
• Feeling light-headed or dizzy
• Less frequent tiredness and nausea⁷

Differences between men and women

Research has shown that women are likely to experience heart attack differently than men, symptoms such as chest pain (angina) are not common in women, most women tend to experience symptoms about a month prior to the attack. Heart attack is one of the leading causes of death in men with one out of four men dying from heart attack. Some symptoms in men include:

• Cold sweats
• Indigestion
• Rapid heartbeats
• Feeling light-headed or dizzy
• Pains in the upper areas of the body i.e neck, back, jaw, stomach
• Angina (chest pain), like an heavy animal is sitting on the chest

Some symptoms in women include:

• Anxiety
• Disturbances in sleep
• Unusual long-lasting fatigues
• Shortness of breath
• Pressure or pain in the middle of the chest
• Pains in the jaw

Differential Diagnosis

Diagnosis of gas pain

In the diagnosis of gas pain, the doctor diagnoses with a medical history or/and a physical examination, in the medical history the doctor asks about information on:

• Symptoms experienced
• Drinking, eating and diet pattern and habits
• Medications, supplements and prescriptions taken by the patient, especially over-the -counter medications
• Past and present medical conditions

Doctors are likely to ask people experiencing symptoms to keep a record of food and drinking habits and type of the foods consumed, as well as when they experience certain symptoms. In this record, the doctor can review certain foods and drinks causing gases and also find out if the patient has a sensitivity to normal amounts of gas or if the patient has excessive gas in their stomach which could be causing gas pain.

During the physical examination, the doctor:

• Checks for signs of swelling or any form of enlargement around the abdomen
• Listens to sounds in the abdomen with a stethoscope 
• Checks for tenderness or pains and taps the abdomen to listen to a drum-like sound which shows the presence of gas in the digestive tract.

Other tests such as blood tests, X-ray, stool tests and a digital rectal exam might be included.

Diagnosis of heart attack

An electrocardiogram (ECG) is a very important test used to diagnose a heart attack, it takes about 5 minutes to do, the ECG measures electrical impulses and activities of the heart, when the heart beats, the ECG records the tiny electrical impulses produced by the heart on to a paper for the doctor to correctly deduce whether the heart is functioning well or not. The ECG helps determine the type of heart attack and confirm the diagnosis of a heart attack.

How to tell the difference between gas pain and a heart attack

Gas pain can be differentiated from a heart attack with the symptoms experienced and it is better to visit the nearest emergency centre, but most times the symptoms experienced by an individual can suggest which of the conditions present. 

Treatment for a heart attack

Surgical treatments include:

• Angioplasty: this is a surgical procedure which involves the insertion of a Special tubing attached to a deflated balloon that is threaded up to the coronary arteries.
• Bypass surgery: Treats blocked heart arteries by creating new passages for blood to flow to your heart muscle.
• Heart transplant: This is a surgical procedure where the doctor removes a diseased or affected  heart and replaces it with a healthy human heart.
• Radiofrequency ablation: A catheter with an electrode at its tip is guided through the veins to the heart muscle to destroy carefully selected heart muscle cells in a very small area.
• Transmyocardial revascularization (TMR): A laser technique which is used to drill a series of holes outside of the heart into the pumping chamber of the heart.⁷

Medication treatments for heart attacks:

• Anti-coagulants
• Vasodilators
• Cholesterol-lowering medications
• Diuretics 

Preventing digestive issues

Most digestive issues can be prevented by:

• Avoidance of food that is highly acidic
• Stick to eating consistent smaller meals
• Drinking more water instead of carbonated drinks like soda
• Avoid eating close to bedtime
• Elevate the head to avoid acid reflux into the oesophagus
• Physical activity to maintain gastrointestinal health
• Maintenance of a healthy diet rich in fruits, vegetables and whole grains.
• Proper food hygiene to avoid the introduction of bacteria which can disturb the digestive process
• Smoking cessation and reduction of alcohol intake

Preventing heart problems

A healthy lifestyle is a good way to reduce all modifiable risk factors of heart attack and stroke: lifestyle modifications include:

• Smoking cessation
• Eating foods with good nutrition and reducing intake of saturated fat, trans fat and cholesterol
• Good physical activity
• Avoiding obesity and striving for a good weight
• Limiting alcohol intake
• Proper management of diabetes and stress.

When to seek emergency medical help

For individuals who might be experiencing gas pain, it is necessary and important to seek emergency help when experiencing gallbladder complications like:

• High fever
• Chills
• Severe abdominal pains
• Yellow eyes

For individuals who might be experiencing a heart attack, it is necessary and important to seek emergency help when :

• Fainting and blacking out
• Severe headache which appears suddenly
• Problems with speaking
• Shortness of breaths
• Unexplainable weight gains
• Swellings in feet and lower legs
• A feeling of numbness on one side of the body or signs of stroke
• Pains radiating from the right or left arm to the back, or shoulder
• Sudden problems with eyesight
• A feeling of a pounding heart¹

Summary

The difference between gas pain and a heart attack is based on the symptoms experienced and where the pain is felt in the body. Symptoms can vary between gender and from person to person and both gas pains and heart attack can be prevented through modifiable factors like healthy eating and physical activities. 

It is absolutely necessary to visit the hospital to be able to tell what the problem is as some of the symptoms may be indicative of another issue. Medical examination and physical examination can help distinguish between gas pain or a heart attack.