Heartburn and Heart Attack: What’s the Difference?
Any type of chest pain is scary. When we feel chest discomfort, many people begin to panic. They assume the worst. But not all chest pain is a heart attack, even when it feels severe.
Heartburn, angina, and heart attack can feel very similar. Even experienced doctors can get them confused if there aren’t any telltale symptoms. That’s why so many people go to A&E with chest pain only to learn it’s acid reflux.
But you can tell them apart. It’s important to understand what heartburn feels like and how it differs from a heart attack. It might save your life or just a trip to the emergency room.
What Is Heartburn, Really?
Heartburn occurs when acid from the stomach enters the oesophagus (or food pipe). The acid irritates the lining, causing discomfort. Because the oesophagus lies just behind the breastbone, that’s where the pain is felt.
Common heartburn symptoms include:
Burning chest pain
Sour taste
Hoarse voice
Worse after eating or lying down
Heartburn isn’t directly related to heart attacks. If you’ve got heartburn, you don’t necessarily have a problem with your heart. That being said, recent research indicates that people with severe acid reflux have a 27% higher risk of having a heart attack compared to those without.
What Happens During a Heart Attack?
A heart attack is very different from heartburn. During a heart attack, the blood vessels supplying your heart muscle suddenly become blocked. Without blood flow, the muscle doesn’t receive oxygen and begins to die.
Common symptoms of a heart attack include:
Chest pain or pressure — often described as tightness, squeezing, or heaviness
Pain spreading to the arm (usually left), neck, jaw, back, or shoulder
Shortness of breath, with or without chest discomfort
Cold sweats, clamminess, or sudden dizziness
Nausea or vomiting
Unusual fatigue, especially in women
Angina can cause a similar pain. It occurs because the arteries supplying your heart are narrowed (but not blocked). When you exercise, they’re not wide enough to supply sufficient blood, causing discomfort. It’s important to always get angina checked, as it can lead to a heart attack.
Why Heartburn and Heart Attacks Can Feel Similar
Most people don’t experience lots of different types of chest discomfort. When we experience any chest pain, it’s easy for us to assume the worst.
It doesn’t help that our brain struggles to tell them apart. Similar nerve pathways mean pain is “referred” to a particular area. So, pain in the oesophagus can appear over the heart, just as a heart attack can cause discomfort in the arm or neck.
Key Differences Between Heartburn and a Heart Attack
Still not sure of the differences? Here’s a quick overview table:
Can Heartburn Be a Sign of a Heart Attack?
Heartburn itself is not caused by a heart attack.
Heartburn (despite the name) specifically describes the presence of acid in the oesophagus. Heart attacks almost never present with heartburn. However, as mentioned earlier, they can be linked. Eating a fatty diet or drinking alcohol can cause heartburn and can increase your risk of a heart attack.
Heart attacks also occur more suddenly, and usually not after a meal or when lying down.
Symptoms That Should Never Be Ignored
If you’re concerned your heartburn is something more serious, don’t ignore it. The longer you leave a heart attack, the more damage it causes. If you notice any of these symptoms, please go to A&E:
Chest pain with exertion
Sudden shortness of breath
Cold sweats or dizziness
Pain lasting longer than a few minutes
A simple (though not completely reliable) test is to take an antacid. If the pain resolves, it could be due to acid. However, if chest pain is new, severe, or unexplained, seek urgent medical help regardless. Most cases of heartburn occur after meals, are linked to posture, and recur over time. Chest pain out of the blue is more concerning.
Ongoing Heartburn? Get the Right Checks
If chest discomfort isn’t a heart attack, it could be heartburn. Recurrent chest pain, especially after meals or when lying down, is distressing.
The Functional Gut Clinic specialises in investigating reflux properly, using evidence-based testing to identify whether reflux is driving your symptoms. We provide clear and accurate results with actions to take going forward, helping you take control of your symptoms.
You might enjoy reading the next related article: Acid Reflux and Back Pain: Can Indigestion Cause Backache?
