Heart Attack vs. Heartburn

Chest pain, nausea, and an upset stomach are symptoms of a heart attack and heartburn.

This comparison of differences between heartburn and heart attack is not 100% specific and only serves to help you differentiate the two conditions to some extent. If there is any confusion or doubt about if you or someone you are with is having heartburn or a heart attack, you call 911 or go to an emergency department immediately.

• Heartburn is a symptom of another condition, for example, gastroesophageal reflux disease (GERD), and usually is caused by stomach acid that irritates the esophagus. A heart attack usually is caused by coronary artery blockage or heart disease.
• Heartburn symptoms often occur after eating a heavy meal, or at night.
• Heart attacks can occur at any time.
• Heartburn pain may begin at the breastbone and travel up toward the throat. You may feel food coming back into the mouth, and have an acidic or bitter taste in your throat along with increased severity pain if you bend over.
• Warning signs of a heart attack often is a pain in the chest that spreads to the shoulders, neck, or arms. The person can develop cold sweat, dizziness, shortness of breath, and possibly nausea and vomiting. These symptoms infrequently or rarely occur with heartburn.
• Heartburn pain usually responds quickly to antacids and/or belching, whereas heart attack pain usually does not respond to oral antacids.
• Heart attacks require other medications and/or treatments.
• Most people that suffer from heartburn pain have discomfort, but the problem is seldom life-threatening. In stark contrast, heart attacks always are considered medical emergencies and need immediate attention, as many heart attacks are life-threatening.

Heartburn

Heartburn (acid reflux) is a symptom, and usually feels like a burning sensation in the chest, under the sternum, and in the esophagus that can extend to the neck, throat, and/or face. Heartburn often is caused by a malfunction in the esophageal sphincter muscle (a muscular valve located between the stomach and the esophagus), which causes regurgitation (reverse flow) of acid from the stomach into the esophagus.

Heartburn is a misnomer because it does not involve the heart. Other names for heartburn include indigestion, dyspepsia, acid reflux, gastroesophageal reflux disease (GERD), pyrolysis, and even "cardialgia."

Heart Attack

A heart attack often is a sudden and sometimes fatal occurrence of coronary thrombosis (coronary artery blockage) that frequently produces chest pain and/or additional pain that may radiate to the neck, jaw, and/or arms. Heart attacks involve the heart and not the esophagus or acid regurgitation.

Because the esophagus and heart are located near each other, many people consider pain in that region as a sign of either heartburn or a heart attack. However, individuals may often not know how to tell heartburn from a heart attack.

A person can have these symptoms with either heartburn or a heart attack. Since the symptoms are so similar, it often makes it difficult for some people to tell if they are having heartburn or a heart attack.

• Chest pain (may or may not rise toward the throat and/or spread to the shoulders, neck, jaw, and/or arms). The pain may linger or subside.
• Nausea
• Upset stomach

Although most of the early signs and symptoms can be the same for heartburn and heart attack, a few are different. A heart attack most often causes signs and symptoms that include:

• Shortness of breath (may be severe)
• Diaphoretic (sweating or a “cold sweat” – produced by fear, anxiety, or illness)
• Increasing chest pain or sudden, severe, and unrelenting chest pain
• Evolving EKG changes
• Nausea and vomiting
• Unusual weakness or fatigue
• Persistent and/or increasing severity of symptoms over minutes

Although heartburn may produce some less severe symptoms, heartburn is rarely life-threatening. In contrast, heart attacks are frequently life-threatening. If there is any doubt in your mind as to whether you or someone you are with has symptoms indicating heartburn or heart attack, you should call 911 immediately to be transported to an emergency department for medical treatment.

Most people with heartburn are diagnosed by the symptoms that they describe to their primary care doctor. However, a definitive diagnosis of heartburn may be made by endoscopy and pH probe data, which is frequently done by gastroenterologists. However, it is common practice for doctors to rule out a heart attack or any other pending cardiac problem to make sure the individual is not suffering from a potentially life-threatening problem.

The two main tests to diagnose heart attack are an EKG (electrocardiogram) and a test to determine the level of certain enzymes in the blood (troponins). Additional tests for a heart attack (or evidence for a potential heart attack) can be done by echocardiogram, chest X-rays, coronary catheterization (angiogram), and exercise stress tests.

Heartburn Treatment

The treatment for heartburn varies with the severity of the disease that causes heartburn. Some people can treat heartburn with diet modifications, for example, avoiding acid-causing foods such as chocolate, caffeine, spicy foods, carbonated drinks, and citrus.

People with mild heartburn may only need only antacids over-the-counter occasionally, for example, Tums or Rolaids to relieve heartburn symptoms.

Moderate to more severe heartburn disease may require histamine receptor antagonists (H2 blockers like Pepcid or Zantac), protein pump inhibitors (PPIs) that reduce stomach acid production, for example, esomeprazole (Nexium), or omeprazole (Prilosec), or even surgery (fundoplication).

Heart Attack Treatment

The treatment for a heart attack may vary somewhat from patient to patient, depending upon the extent or severity of the attack. In general, however, a heart attack is treated in either the emergency department and/or the hospital intensive care unit, cardiac catheterization unit, or telemetry unit. Since a heart attack may be due to complete or partial coronary artery blockage, the treatments may vary and may overlap depending on your cardiologist’s decision.

The prognosis for the majority of people with heartburn is good to excellent if they try to prevent any future problems. Severe heartburn has a reduced prognosis as it can lead to esophageal damage, Barrett’s esophagus, and/or inability to swallow due to stricture formation.

The prognosis of a heart attack may be good to fair if treated immediately; however, the prognosis decreases if a large amount of heart muscle is damaged or destroyed during a heart attack. Complications of heart attacks include irregular heartbeat (arrhythmias), heart valve damage, heart failure, additional heart attacks, and/or sudden death.

Complications occur more frequently after a person survives a heart attack. Complications occur less frequently after heartburn.

There is a good possibility that both heartburn and a heart attack can be reduced or prevented. A balanced diet along with exercise is key to preventing both heartburn and or heart attack. In addition to treating the underlying cause of heartburn, there are lifestyle changes and natural home remedies that may help prevent it.

• Eat small, more frequent meals.
• Do not eat about three hours before bedtime.
• Elevate the head of your bed by about 6 inches.
• Do not eat or drink foods that are acidic or trigger acid development in the stomach.
• If you are obese, lose weight.
• Stop smoking and/or drinking alcohol.
• Try to take your heartburn medication at the same time each day.

The chances of reducing or stopping recurrent or initial heart attacks may be prevented by lifestyle changes, for example:

• Stop smoking.
• Eat a balanced diet and exercise.
• Reduce stress by doing yoga, meditation, and/or increasing relaxation.
• Keep your blood pressure in the normal range.
• Take appropriate medication to treat other medical problems such as diabetes.
• If you are obese, lose weight.
• Keep your cholesterol levels within the normal ranges.