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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The Latest Testing Information

The world of COVID-19 testing is very complex and changing rapidly. But gratefully, unlike early on in the pandemic, tests are available for everyone who wants one, whether they have symptoms or not. Below is a list of common questions, along with answers from SVMC’s Laboratory Services Director Karen Bond and SVMC’s Director of Perioperative Services Tanya Cowder, MSN, RN, CNOR.

What are the reasons someone may get tested for COVID-19, even if they don't have symptoms? People without symptoms of COVID-19 are being tested when they are admitted to SVMC, before being discharged to other facilities, before scheduled surgeries, or because they may have been exposed to the virus. Primary care providers are also able to order a test for those who need to return to work or school or to end quarantine or isolation. And anyone can be tested through the Vermont Department of Health's Pop-Up Clinics.

What types of tests are available for detecting active cases of COVID-19? SVMC offers Polymerase Chain Reaction (PCR) testing that is processed at both outside labs and our own lab, depending on how quickly results are needed. PCR, which was pioneered by American biochemist Kary Mullis in 1983, actually amplifies and detects the presence or absence of small gene sections. In this case, it determines whether or not COVID-19 is present.

The specimen is most often taken from deep in the nose-throat passageway (nasalpharyngeal). Patients experience eye watering and a burning sensation for 30 seconds or less. The test can also be taken from inside the nose (anterior nares), depending on the patient population. The most common type of test, like those administered both at SVMC’s drive-up testing station and at the Vermont Department of Health’s Pop-Up Clinics, is greater than 90% sensitive (meaning that the test picks up the virus, if it is present) and greater than 90% specific (meaning the test detects the COVID-19 virus, as opposed to other viruses).

How do I get my results and what should I do? Results are usually provided by a primary care provider within 48 hours. Your primary care provider will share specific directions regarding what you should do next. The Centers for Disease Control and Prevention is sharing this table, which provides a synopsis of tests, what results mean, and guidance for what to do. If the test is positive, the Vermont Department of Health may call before the primary care provider to initiate contact tracing.

Are all of the tests sufficiently available? Yes. Anyone with an order from their primary care provider can be tested at the drive-up testing site at SVMC. Anyone can be tested at the Vermont Department of Health's Pop-Up Clinics. Visit https://humanresources.vermont.gov/popups for times, dates, and locations. Tests for inpatients at the hospital are also in adequate supply.

Important Note: Remember test results offer a snap shot of the current active viral load. A negative test result doesn’t reveal whether you have been exposed in the past or predict whether you will be infected in the future. Whether or not the result is positive, we should all continue to wash our hands frequently, wear masks when in public and in proximity to those outside of our household, and stay 6 feet from others.

What about antibody tests? Antibody tests (serology) are also available. It does not tell you if you have active disease. Antibody tests check for antibodies that appear in the blood between about 1 – 3 weeks after symptom onset and may remain as long as a lifetime. Antibody tests may be positive while a person is infected. It is not yet known whether these antibodies protect against reinfection with the COVID-19 virus. For many other similar viruses, antibodies are protective for years or longer, but we do not yet have adequate data to know for COVID-19. Patients who would like the test would get a referral from their primary care provider and come to the SVMC Lab to have blood drawn. Results are delivered by the primary care provider.

Those who receive a positive antibody test or who have recovered from COVID-19 may qualify to donate plasma with the American Red Cross. The plasma, which includes antibodies, may help those fighting the disease. Learn more at https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html.

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