Chest Pain: Is it a Heart Attack or Heartburn?

By Thomas Galski, DO, Cardiologist—Virtua Cardiology
Gregory Seltzer, MD, Gastroenterologist—Virtua Gastroenterology

Most people experience minor chest pain now and then. When it happens, you might downplay it or wonder if it’s something serious. 

Since gastroesophageal reflux disease (GERD) and heart attacks have similar symptoms, it’s understandable why feeling chest pain might make you pause before calling 911. 

But while some symptoms might feel similar, the outcomes are VERY different. Delaying treatment of a heart attack can cost you your life. On the other hand, no one wants to go to the ER if heartburn could be cleared up with an antacid. Here’s what you need to know to assess your symptoms. 

How similar are the symptoms of heartburn and a heart attack?

GERD (also known as heartburn), angina (chest pain that may be due to artery disease) and heart attack may feel very much alike. Chest discomfort described as pain, pressure or burning can be common to all of these disorders along with symptoms like nausea, indigestion or upper abdominal pain. 

Even experienced doctors can't always tell the difference from a patient’s medical history and a physical exam. That's why if you go to the ER because of chest pain, you'll immediately have tests to rule out a heart attack.

What should you do if you have chest pain, and you're not sure what's causing it?

• If you have persistent chest pain and you’re not sure it's heartburn, call 911. 
• If you had an episode of unexplained chest pain that went away within a few hours and you didn’t seek medical attention, call your doctor. 

Both heartburn and a developing heart attack can cause symptoms that subside after a while. The pain doesn't have to last a long time to be a warning sign. 

Heart attack symptoms can also include:

• Sweating
• Shortness of breath
• Nausea or vomiting
• Pain that spreads from the chest to the neck, jaw or one or both shoulders or arms
• Dizziness or lightheadedness, associated with fast or irregular pulse

In someone over age 40 who doesn't have a history of heartburn, all chest pain should be treated as cardiac chest pain until proven otherwise. Call 911 or go to the closest ER. 

If you have a history of GERD and your symptoms are consistent with GERD, it’s reasonable to try an antacid. Generally speaking, if someone has chest discomfort that’s relieved by burping, this would indicate heartburn or something gastrointestinal-related.

What should you do if pains come and go?

Call your doctor if you experience the following:

• You have chest pain that started within the past two months and is getting more severe.
• You have chest pain that happens several times per day.
• You have chest pain that suddenly becomes more frequent or lasts longer with exertion.
• You have chest pain that occurs at rest or that awakens you from sleep.

DO NOT ignore chest pain. It may sound cliché, but it’s better safe than sorry. 

Call 911 and get to an ER. Acting fast can save your life.

Updated December 3, 2018