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.