The Difference Between Heartburn and a Heart Attack

Sudden chest pain is one of those symptoms that gets—and deserves—your attention. While it’s natural to wonder whether you’re having a heart attack, there’s also a possibility that what you’re experiencing is heartburn.

How do you know whether to reach for the antacids or the phone to call 9-1-1? The truth is, it’s not easy. 

The main symptoms of heartburn and a heart attack—a painful sensation or feeling of pressure at the center of your chest—are sometimes nearly indistinguishable.

What is different between the two is the cause of the discomfort.

In the case of a heart attack, an individual experiences pain when one of the arteries supplying blood to the heart becomes clogged, cutting off oxygen supply to the heart muscle. Heartburn, on the other hand, occurs when acid in the stomach flows up the esophagus, causing a burning sensation as the stomach acid irritates the lining of the esophagus. Despite its name, heartburn has nothing to do with your heart, but the location of the pain experienced is very close to the heart.

Differentiating between heartburn and a heart attack may require testing in a hospital or health clinic setting. Heartburn does not cause sweating, shortness of breath, jaw pain, or pain in one or both arms. However, symptoms of a heart attack may come on slowly or very suddenly and can range from mild to severe. In addition, symptoms can vary dramatically from person to person and may be strikingly different between men and women. 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.

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

Trey Dobson, MD, is the chief medical officer at Southwestern Vermont Medical Center.