• Is It Heartburn or a Heart Attack?

    The pain experienced during a heart attack and during a severe heartburn episode can be difficult to distinguish. It is not unusual for people to mistake symptoms of heart disease (such as angina and even a heart attack) for heartburn.

    Similarly, many people go to the emergency room each year out of fear that they are having a heart attack, only to find out they have severe heartburn. In fact, it often takes medical testing to make the determination.

    Pain can be difficult to distinguish

    Here are some possible differences between heartburn and heart attacks.

    Typical heartburn symptoms

    • A sharp, burning sensation below the breastbone or ribs
    • Burning sensation may move up toward the throat
    • Pain often occurs after eating, particularly when lying down
    • Pain increases when bending over, lying down, exercising or lifting heavy objects
    • Bitter or sour taste in your mouth or at the back of the throat
    • Symptoms respond quickly to antacids

    Note: Call for emergency medical services right away if you have any chest pain, even if you think it may be heartburn.

    Typical heart attack symptoms

    • A feeling of uncomfortable fullness, pressure, squeezing, tightness or pain in the center of the chest that lasts more than a few minutes or goes away and comes back
    • Symptoms brought on by physical exertion or emotional stress
    • Pain or discomfort that spreads to one or both arms, the back, stomach, neck or jaw
    • Shortness of breath
    • Other symptoms, such as:
      • Breaking out in a cold sweat
      • Nausea
      • Lightheadedness
      • Fainting
      • Rapid heartbeat

    Other causes of chest pain

    Heartburn and heart attacks are not the only conditions that can cause chest pain. Other problems that can cause chest pain include:

    • Other heart conditions, such as:
      • Coronary spasm – arteries supplying blood to the heart go into spasm, temporarily limiting blood flow to the heart muscle
      • Pericarditis – inflammation of the sac surrounding the heart
      • Aortic dissection – rare, but dangerous condition in which the inner layers of the aorta separate
    • Panic attack – periods of intense fear accompanied by anxiety, chest tightness, rapid heartbeat, rapid breathing, profuse sweating and shortness of breath
    • Costochondritis – inflammation of the rib cage cartilage
    • Muscle-related chest pain – often accompanies fibromyalgia and other chronic pain syndromes
    • Injured ribs, pinched nerves – can cause localized chest pain
    • Shingles – infection of a nerve root, caused by reactivation of the chickenpox virus
    • Pleurisy – inflammation of the lining of the chest and lungs, which causes chest pain that increases with coughing, inhalation or deep breathing
    • Pulmonary embolism – a blood clot lodged in the artery of the lung
    • Other lung conditions, such as:
    • Gallbladder or pancreas problems – gallstones or inflammation of the gallbladder or pancreas can cause abdominal pain, which can radiate to the chest
    • Disorders of the esophagus – swallowing disorders such as esophageal spasms and achalasia (failure of esophageal muscle to relax)
    • Cancer – cancer involving the chest or that has spread from another part of the body

    Seeking medical attention for chest pain

    Chest pain can be difficult to interpret.

    Call 911 for emergency medical services right away if you have any chest pain, especially if you have other signs and symptoms of a heart attack.

    Do not have someone drive you to the emergency room. Emergency medical crews can provide treatment on the way to the hospital.


    The American College of Gastroenterology – www.acg.gi.org

    American Heart Association – www.heart.org


    Gastroesophageal reflux disease (GERD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 11, 2016. Accessed May 10, 2016.

    Heart attack. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/Heart-Attack%5FUCM%5F001092%5FSubHomePage.jsp. Accessed May 10, 2016.

    Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerd. Accessed May 10, 2016.

    ST-elevation myocardial infarction (STEMI). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 5, 2016. Accessed May 10, 2016.

    Revision Information

    This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

    Copyright © 2012 EBSCO Publishing. All rights reserved.

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