Your Chest Pain: Heartburn, Heart Attack, or Something Else?

By Robert Shmuts, DO, Gastroenterology — Virtua Gastroenterology

You’ve probably felt it—the burning sensation in your chest after eating a large or spicy meal. It’s probably heartburn or gastroesophageal reflux disease (GERD), which occurs when digestive acid from your stomach flows back into your esophagus.

Before you pop an antacid and resolve to eat better next time, consider your pain may have a different cause—one that requires treatment from a health care provider.

What’s Causing My Symptoms?

Heartburn can mean different things to different people. For some, it can be burning in the chest. For others it can be a sore throat, belching, a bad taste in the back of your throat, food that comes back up, chronic cough, or hoarseness.

While reflux is a common cause of heartburn, there are a number of other conditions that produce similar symptoms.

Other causes for chest pain include:

Heart attack—Occurs when an artery supplying blood to the heart becomes blocked. While the chest discomfort with heart attack and heartburn can be similar, with a heart attack the pain can radiate to the arms, neck, jaw, and back. Other heart attack symptoms include shortness of breath, breaking out in a cold sweat, lightheadedness, and fatigue. Call 911 for emergency care.

Angina—Caused by a narrowing of the coronary arteries, angina pain usually goes away with rest or medication. If the pain does not subside after a few minutes, call 911.

Hiatal hernia—Occurs when the upper part of the stomach bulges through the diaphragm. Food and acid can back up into the esophagus, leading to heartburn.

Changes to the esophagus—Occurs when cells lining the esophagus change and grow out of control. GERD is a risk factor for precancerous Barrett’s esophagus and esophageal cancer.

Bacterial infection—Helicobacter pylori (H. pylori) bacterial infection of the stomach and small intestine causes inflammation of the stomach lining and ulcers. You may experience abdominal pain, upset stomach, vomiting, burping, bloating, and lack of appetite.

Gallbladder disease—Bile produced by the liver for digestion and stored in the gallbladder backs up into the stomach and esophagus.

Gastroparesis—Occurring in people with conditions like diabetes or lupus, the stomach is unable to empty itself of food.

Got GERD?

If your health care provider determines GERD is the culprit of your discomfort, there are steps you can take for relief.

Overeating, eating before bedtime, spicy or high-fat foods, citrus fruits and juices, tomatoes, peppermint, alcohol, caffeine, carbonated drinks, and chocolate all can trigger heartburn.

Obesity, stress, pregnancy, smoking, and certain medicines also can increase your risk.

If you only get reflux after you have beers and spicy wings with your buddies once a month, you may need some lifestyle modifications, but you don’t need further treatment.

If you are getting it more often, you may need to take medication. Medication may include antacids and proton pump inhibitors to block acid production and heal the esophagus.

Get Help

Remember, chest pain is not normal. Don’t ignore your symptoms and think they will just go away. Get checked out—it could save your life.

Put Your Gut Troubles in the Rearview Mirror

If stomach issues affect you often, it may be time for an evaluation with a gastroenterologist. Find a Virtua Gastroenterology practice near you and schedule an appointment online today.

Updated February 9, 2022