Heart Attack vs Heartburn

Overview

People often consider chest pain as the only related symptom of a heart attack. However, chest pain can occur due to a variety of less serious reasons, such as gastro-oesophageal reflux disease (GORD), pneumonia, or panic attacks.

Gastroesophageal reflux disease causes a burning sensation in the chest called heartburn. Heart attack and heartburn are different conditions, but share similar symptoms, including chest pain. For this reason, people often get confused about the real reason for their chest pain. While heartburn can be frustrating, heart attacks are serious and life-threatening medical emergencies. Therefore, understanding the difference between both conditions is essential.

What is a heart attack?

A heart attack happens when the blood supply to the heart muscles is severely blocked or disrupted. The reduction occurs due to an accumulation of a fatty substance called plaque, which causes obstruction in one or more of the coronary arteries. Coronary arteries are the tiny vessels responsible for supplying blood to every part of the heart. 

The process of obstruction or narrowing of the artery due to plaque, which restricts the blood flow, is medically known as arteriosclerosis.

Sometimes, the plague ruptures and forms a clot inside the vessels, resulting in more blockage. The obstruction causes the cardiac muscles to lose their function due to a lack of blood supply and become infarcted, which is medically referred to as a myocardial infarction.

According to the British Heart Foundation, coronary heart disease (CHD) is one of the most common causes of a heart attack. In the UK, nearly 100,000 hospital admissions each year are due to heart attacks, meaning 1 every 5 minutes.1

Symptoms of a heart attack

Heart attacks have a variety of symptoms, and may even be influenced by gender. The most common noticeable symptoms of a heart attack include:

  • Chest discomfort - often felt as a tight, throbbing, or dull pain at the centre of the chest.
  • Shortness of breath.
  • Lightheadedness or dizziness.
  • Irregular heartbeat.
  • Pain radiating to the arms, shoulders, jaw, or neck.
  • Nausea.
  • Vomiting.
  • Cold sweat.
  • Unusual fatigue.

What is heartburn?

Despite its name, heartburn occurs when stomach acid travels back into the throat (acid reflux). Generally, when food is consumed, the lower oesophageal sphincter (the muscular ring around the oesophagus) stretches only to allow food contents to pass down into the stomach. The lower oesophageal sphincter is responsible for ensuring that the flow of food content is functioning properly. Acid reflux happens when this one-way system malfunctions, causing the food content to reverse back to the throat. This causes a burning sensation in the chest behind the breastbone, commonly referred to as "heartburn".

There are several factors that can cause heartburn. Sometimes, any inflammation of the oesophageal lining (oesophagitis) can result in heartburn.

Other factors may include:

  • Smoking.
  • Pregnancy.
  • Weight gain.
  • Consumption of spicy foods.

Heartburn is typically very common and is easily managed. In the UK, around 1 in 4 adults are affected by heartburn.2 If heartburn becomes frequent or does not respond to the non-prescribed medications, then it is advised to seek immediate medical attention to rule out any serious conditions. 

Heartburn symptoms

When someone experiences heartburn, they may observe the following symptoms:

  • Burning feeling right behind the breastbone, which may persist for a few minutes to several hours.
  • Burning pain that moves towards the throat.
  • Difficulty swallowing.
  • Worsening of discomfort when bending over or lying down.
  • Burning sensation in the chest after eating or at night.
  • A bitter taste in the mouth.
  • Bad breath.
  • Feeling food stuck in the throat.
  • Coughing or hoarseness. 

Differences between symptoms of heartburn and heart attack

To understand the key difference between a heart attack and heartburn, you should consider the following factors:

  • The sensation of the chest pain: The chest pain (angina) that is felt during a heart attack is often observed as a tight, heavy, or stabbing pain in the chest. Whereas chest pain due to heartburn is often felt as a burning sensation.
  • Location of the pain: During a heart attack, the chest pain is felt in the centre or slightly to the left side of the chest, which often radiates to the jaw, neck, or to nearby extremities. Meanwhile, in the case of heartburn, the pain is mostly localised to the centre of the chest.
  • The accompanying signs: By comparison, heartburn is followed by regurgitation (the feeling of food coming up to the chest), while heart attacks are accompanied by rapid heartbeats. Moreover, in comparison to angina, the chest pain from heartburn often worsens when a person bends over or lies down.

How much do the symptoms of heartburn and heart attack overlap?

The symptoms of heartburn and heart attacks are very much alike. Even doctors may not be able to differentiate between your medical history and physical examination. The most noticeable feature of both conditions is chest pain.

Other overlapping symptoms may include:

  • Nausea.
  • Vomiting.
  • Fatigue.
  • Abdominal pain.
  • Indigestion.

How to manage chest pain if you are not sure what's causing it?

If you are unsure of the cause of chest pain, then it is best to seek medical attention immediately to rule out any serious problem.

  • Meanwhile, you can manage your symptoms by simply laying down in a comfortable position with the head in an elevated position.
  • Taking an aspirin (if you are not allergic) may help alleviate the chest pain.
  • Sometimes, chest pain is often related to muscular strain. Using a cold compress may help reduce the pain.
  • Gas may also cause chest pain; drinking lukewarm fluids may suppress the pain if triggered by bloating or gastric issues.

Treatment for heart attack

The efficient treatment determined by medical professionals may include a combination of the following options:

  • Medicines: The doctors may prescribe ACE inhibitors, anticoagulants, statins, or beta blockers to prevent blood clots and reduce cholesterol levels.
  • Medical procedures: Medical professionals may use a clot-busting medicinal approach to break down clots in the coronary arteries. Another non-surgical option is percutaneous coronary intervention, which aims to open the blockages in the narrowed arteries.

The surgical approach may include a bypass to provide a new route for blood flow to the heart.

Other treatment options include:

  • Lifestyle changes – following an exercise regimen or diet plan.
  • Cardiac rehabilitation.

Treatment for heartburn

The approach for treating heartburn may consist of a combination of over-the-counter medications, home remedies, and lifestyle changes. It is recommended that you consult your doctor to identify the best treatment.

  • Antacid medicines: These are prescribed as a first-line treatment to neutralise stomach acids.
  • H2 blockers and proton pump inhibitors (PPIs): These medicines help alleviate symptoms and reduce stomach acid production.
  • Lifestyle changes: Introducing healthy practices can help to limit symptoms, such as eating food in smaller portions and avoiding foods that can trigger heartburn.

When to call a doctor

It is best to keep an eye on the heart attack symptoms and learn when it is time to consult a doctor. However, it is advised to seek your consultant immediately and not to delay if any of the following symptoms persist:

  • Unexpected severe radiating chest pain.
  • Heart rate over 150 beats per minute.
  • Shortness of breath, which does not subside even when at rest.
  • Disturbances in sleep patterns.
  • Excessive sweating.
  • Unusual fatigue.
  • Frequent headaches.
  • Loss of consciousness.

When to see a doctor for heartburn

Most of the symptoms of heartburn can be treated at home. However, if any of the symptoms persist for more than two weeks, you should call your doctor. This may include the following symptoms but is not limited to:

  • Burning sensation in the chest, which appears twice per week.
  • Worsen chest pain or chest discomfort that radiates to the arm, jaw, or shoulders.
  • Persistent nausea.
  • Unexplained weight loss.
  • Loss of appetite.
  • Chronic cough.
  • Difficulty eating.
  • Symptoms do not subside despite using prescribed medications.

Summary

Heart attack and heartburn are two different health conditions that are often misunderstood due to their overlapping symptoms. One of the most noticeable symptoms in both conditions is chest pain. Although heartburn is fairly common, chest pain caused by a heart attack can impose serious, life-threatening conditions. Learning how to distinguish between these two conditions and their overlapping symptoms can help you identify when to consult a doctor and manage the right course of treatment.

References

  1.  “Facts and Figures.” British Heart Foundation, https://www.bhf.org.uk/what-we-do/news-from-the-bhf/contact-the-press-office/facts-and-figures. Accessed 31 Nov. 2022.
  2. “Heartburn & Acid Reflux | Causes, Symptoms & Treatment.” Guts UK, https://gutscharity.org.uk/advice-and-information/symptoms/heartburn-and-reflux/. Accessed 31 Nov. 2022.
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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Sadaf Ahmed

Master of Science - MSc, Physiology, Clinical & Molecular Hematology, Karachi University, Pakistan

Sadaf is an experienced writer who creates a quality and well-researched scripts particularly related to Health Sciences.

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