Heartburn or heart attack: Can you tell the difference?
Kathryn Czaplinski
/ Categories: WELLNESS, 2024

Heartburn or heart attack: Can you tell the difference?

With all the indulging that’s done over the holiday season, it’s easy to write off burning and pain in the chest to heartburn and carry on. But did you know that more people die from heart attacks during the last week of December than at any other time of the year?

Given your life is literally on the line, it’s important to understand how heart attacks and heartburn differ and what symptoms should make you concerned.

Even though the symptoms of heartburn and a heart attack—a painful sensation or feeling of pressure at the center of your chest—can be nearly indistinguishable, the causes of the discomfort are quite different.

In the case of a heart attack, pain is experienced when one of the arteries supplying blood to the heart becomes clogged. Heartburn, on the other hand, occurs when acid in the stomach flows back up the esophagus, causing a burning sensation or pain in the center of your chest. So, despite its name, heartburn has nothing to do with your heart, but the location of the pain experienced is often very close to the heart.

While both conditions can lead to a painful sensation or feeling of pressure at the center of your chest, there are some symptoms unique to each that can help you determine if you’re facing a life-threatening medical emergency or not. For example:

  • Heartburn tends to occur after eating and causes temporary discomfort or burning anywhere from the upper abdomen to the throat.
  • A heart attack can cause sweating, shortness of breath, dizziness or lightheadedness; nausea and/or vomiting, weakness or discomfort in the arm or shoulder, and pain, numbness, or tingling in the neck or jaw.
  • Heartburn cause bloating, belching, a bad taste in the mouth, a sore throat, or difficulty swallowing. 
  • A heart attacks can occur at any time and may come on slowly or very suddenly with symptoms ranging from mild to severe
  • Heartburn is often described as a burning or stabbing sensation while the pain from a heart attack is said to feel like pressure, tightness, squeezing, or heaviness.

In many cases, even healthcare providers cannot tell the difference between heartburn and a heart attack by symptoms alone. Further complicating things is the fact that the symptoms of a heart attack can vary dramatically from person to person and are often strikingly different between men and women. Additional screenings, including electrocardiograms (ECGs) and blood work, are essential to ensuring the correct diagnosis.

Anyone who suspects that they or someone else is having a heart attack should immediately call 9-1-1 or go to the emergency room. It’s always better to learn you have heartburn at the hospital than to remain at home and suffer a life-altering—or -ending—heart attack.

If you are experiencing recurring heartburn, contact your doctor. Left untreated it can lead to serious problems including inflammation and narrowing of the esophagus, dental decay, aspiration pneumonia, and even cancer.

Scott Rogge, MD, FACC, is the medical director at Southwestern Vermont Medical Center Cardiology.

 

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Emergency Department: Open, Ready, Safe. 

The last 3 months have been a uniquely challenging experience in the SVMC Emergency Department (ED) and emergency departments and hospitals all over the country and the world. I am very proud of all our staff has done and continues to do to ensure safe care for patients during this era of COVID-19. We are grateful that cases of COVID-19 in our area have been the lowest in the U.S. and have decreased even further over the past several weeks. We are also heartened to see that patients who had been avoiding the ED are now confident to return to get the care they need.

It may be surprising to hear that over the past few months, the sickest patients we have seen in the ER have not had COVID-19. Many people have refrained from seeking care for serious medical problems due to the fear of being exposed to the virus, assuming that the hospital was not a safe place to be and not recognizing the seriousness of their symptoms. The most challenging moments of the past several months have involved critically ill patients who tried to stay away for far too long due to fear of being exposed to COVID-19. We have had many sad moments trying to care for those who waited until it was too late for us to help with conditions that could have been easily treated if presented sooner.

One might expect that the greatest challenges related to the pandemic were those needed to adapt our facilities and procedures and the work of caring for sick COVID-19 patients. SVMC is fortunate to have built a strong foundation of safety and infection-prevention methods over many years, which made this transition much easier. Still, when it became apparent that we were going to see COVID-19 cases coming through our doors, we implemented many COVID-specific changes very quickly.

From day one our staff have all been fully trained to use protective equipment effectively, to focus on cleaning and disinfecting, and to move patients safely through the new areas created to keep them safe. We also spaced the waiting room chairs to allow for plenty of distance and initiated drive-by testing to keep potentially contagious people outside and away from other patients.

We immediately increased our standard of protective equipment we use. For example, all staff who relate with patients now wear both a mask and protective shield, which is a proven and effective strategy to prevent transmission. Those staff who work with patients with respiratory or other contagious symptoms also wear a gown and advanced respirators developed in cooperation with Mack Molding in Arlington. They look strange, but they help us deliver care safely.

We also quickly built special spaces and units in the hospital to treat and segregate patients with respiratory symptoms who might be contagious from those with other routine medical problems. Outpatients with symptoms that could be related to COVID-19 are directed to a spacious area called the Respiratory Evaluation Center. There they can be taken to a safe treatment space called a negative-pressure room without encountering any patients who are using the ED for other reasons or any staff who are not fully equipped with protective gear. There are similar, safe, negative-pressure units for those who require treatment in the ED or hospital.

Our hard work paid off. We have treated a number of COVID-19 patients in our ED and, as far as we know, not a single staff member was sickened in relation to their work here, and no patients have contracted COVID-19 while under our care. With our current procedures and drastically declining COVID numbers, we are confident that we can continue that trend. Furthermore, SVMC recently received a perfect score on a rigorous survey specifically designed to judge our ability to prevent transmission of COVID-19. At this time our ED is safer than just about any other public place you could go.

My goal in writing today is to communicate that SVMC’s Emergency Department is open, ready, and safe. If you need emergency care, we are here and we can care for you safely. Please do not defer emergency care until it is too late for us to help. While many symptoms can represent a serious medical problem, the most concerning are chest pain, difficulty breathing, fast heart rate, confusion, high fever, intense headache, drooping face, dehydration, or weakness. Of course, with any other symptom you feel indicates a serious problem, come in right away or call 9-1-1.

For us, spending time with patients and connecting on a personal level is the best part of our jobs. We take pride in our life-saving role in our communities and the work we have been able to do during the pandemic, but we cannot help if you do not come in. Please don’t hesitate to get the care you need when you need it.

Adam Cohen, MD, is a board-certified emergency medicine physician at Southwestern Vermont Medical Center. He also serves as the chair of the Department of Emergency Medicine and the medical director of SVMC’s Emergency Department.

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