How can you tell if chest pain is heartburn or a heart attack. What are the key differences in symptoms between acid reflux and cardiac issues. When should you seek emergency medical care for chest discomfort.

Understanding the Difference: Heartburn vs. Heart Attack

Experiencing chest pain can be alarming, as it’s often difficult to determine whether the discomfort is due to heartburn or a potentially life-threatening heart attack. While both conditions can cause similar symptoms, there are key differences that can help you distinguish between the two.

What is Heartburn?

Heartburn, also known as acid reflux, occurs when stomach acid flows back into the esophagus. This can cause a burning sensation in the chest, often mistaken for cardiac issues due to its location. Heartburn is typically triggered by certain foods, eating habits, or lying down shortly after meals.

Common Symptoms of Heartburn

• Burning sensation in the chest, behind the breastbone
• Pain that worsens when bending over or lying down
• Bitter or acidic taste in the back of the throat
• Difficulty swallowing
• Sensation of food sticking in the throat or chest

Heart Attack Symptoms

Heart attacks, on the other hand, are a medical emergency caused by blocked blood flow to the heart. The symptoms can vary between individuals, particularly between men and women.

• Severe chest pressure or tightness
• Pain radiating to arms, shoulders, neck, or jaw
• Shortness of breath
• Nausea or vomiting (more common in women)
• Cold sweats
• Lightheadedness or dizziness

Triggers and Risk Factors for Acid Reflux

Understanding what causes heartburn can help you prevent and manage symptoms effectively. Several factors can contribute to acid reflux:

Common Heartburn Triggers

• Spicy, fatty, or acidic foods
• Caffeine and alcohol
• Large meals
• Eating close to bedtime
• Tight-fitting clothing
• Smoking
• Stress

Do certain foods consistently trigger your heartburn symptoms? Keeping a food diary can help identify your personal triggers and guide dietary changes to reduce discomfort.

Lifestyle Changes to Prevent Heartburn

Making simple adjustments to your daily habits can significantly reduce the frequency and severity of heartburn episodes:

1. Eat smaller, more frequent meals
2. Avoid lying down for at least 3 hours after eating
3. Elevate the head of your bed by 6-8 inches
4. Wear loose-fitting clothing
5. Maintain a healthy weight
6. Quit smoking
7. Limit alcohol and caffeine intake

Is stress exacerbating your heartburn symptoms? Incorporating stress-management techniques like meditation, deep breathing exercises, or regular physical activity can help alleviate both stress and acid reflux.

When to Seek Medical Attention for Chest Pain

While heartburn is generally not life-threatening, it’s crucial to recognize when chest pain may indicate a more serious condition. Seek immediate medical attention if you experience:

• Severe chest pain or pressure, especially if it spreads to your arms, neck, or jaw
• Shortness of breath
• Nausea or vomiting
• Dizziness or lightheadedness
• Irregular or rapid heartbeat
• Chest pain accompanied by sweating or clamminess

Are you experiencing any of these symptoms? Don’t hesitate to call emergency services or have someone take you to the nearest emergency room immediately.

Gender Differences in Heart Attack Symptoms

It’s important to note that heart attack symptoms can manifest differently in women compared to men. Women are more likely to experience:

• Nausea or vomiting
• Shortness of breath
• Back or jaw pain
• Extreme fatigue

These symptoms can be subtle and easily mistaken for other conditions, leading to delayed treatment. Women, especially those over 50 with risk factors like diabetes or obesity, should be particularly vigilant about unusual symptoms and seek medical attention promptly.

Diagnostic Procedures for Chest Pain

When you visit a healthcare provider with concerns about chest pain, they may perform several tests to determine the cause:

For Suspected Heartburn

• Upper endoscopy
• Esophageal pH monitoring
• Esophageal manometry

For Suspected Heart Issues

• Electrocardiogram (ECG)
• Blood tests to check for cardiac enzymes
• Stress tests
• Coronary angiogram

Are you experiencing recurring chest pain? Keeping a detailed record of your symptoms, including when they occur and what seems to trigger them, can help your healthcare provider make an accurate diagnosis.

Treatment Options for Acid Reflux and GERD

If you’re diagnosed with chronic acid reflux or gastroesophageal reflux disease (GERD), several treatment options are available:

Over-the-Counter Medications

• Antacids for quick relief of occasional heartburn
• H2 blockers to reduce stomach acid production
• Proton pump inhibitors (PPIs) for more severe or frequent symptoms

Prescription Medications

• Stronger versions of H2 blockers and PPIs
• Prokinetics to strengthen the lower esophageal sphincter

Surgical Options

For severe cases that don’t respond to lifestyle changes and medication, surgical interventions may be considered:

• Fundoplication: A procedure to strengthen the lower esophageal sphincter
• LINX device: A ring of tiny magnetic beads placed around the junction of the stomach and esophagus

Have you tried over-the-counter treatments without success? Consult with your healthcare provider to explore prescription options or to discuss whether you might be a candidate for surgical intervention.

Preventing Complications of Chronic Acid Reflux

While occasional heartburn is common, chronic acid reflux can lead to more serious complications if left untreated:

• Esophagitis: Inflammation of the esophagus
• Barrett’s esophagus: Changes in the lining of the esophagus that increase cancer risk
• Esophageal strictures: Narrowing of the esophagus due to scar tissue
• Dental problems: Erosion of tooth enamel from stomach acid

Regular check-ups and following your treatment plan can help prevent these complications. If you experience frequent heartburn, work with your healthcare provider to develop a comprehensive management strategy.

Heart Health and Acid Reflux: Understanding the Connection

While heartburn and heart attacks are distinct conditions, there may be some connections between digestive health and cardiovascular health:

• Shared risk factors: Obesity, smoking, and a sedentary lifestyle can contribute to both heart disease and GERD
• Stress: Can exacerbate both heart problems and acid reflux
• Medications: Some heart medications may affect acid production or lower esophageal sphincter function

Maintaining a healthy lifestyle that includes a balanced diet, regular exercise, stress management, and avoiding tobacco can benefit both your digestive and cardiovascular systems.

Do you have risk factors for both heart disease and GERD? Discuss comprehensive prevention strategies with your healthcare provider to address both conditions simultaneously.

The Role of Diet in Managing Heartburn and Heart Health

A well-balanced diet plays a crucial role in managing heartburn and promoting heart health. Consider incorporating these dietary strategies:

Foods to Avoid or Limit

• Citrus fruits and juices
• Tomato-based products
• Spicy or fatty foods
• Chocolate
• Peppermint
• Carbonated beverages

Heart-Healthy and Reflux-Friendly Foods

• Lean proteins (chicken, fish, tofu)
• Complex carbohydrates (whole grains, sweet potatoes)
• Non-citrus fruits (bananas, melons, apples)
• Vegetables (green beans, broccoli, asparagus)
• Healthy fats (avocado, olive oil, nuts in moderation)

Are you struggling to balance a heart-healthy diet with acid reflux management? Consider working with a registered dietitian to create a personalized meal plan that addresses both concerns.

The Importance of Sleep Position for Acid Reflux Management

Your sleep position can significantly impact the frequency and severity of nighttime heartburn. Consider these tips for better sleep with acid reflux:

• Elevate the head of your bed by 6-8 inches
• Use a wedge pillow to keep your upper body elevated
• Sleep on your left side to reduce reflux episodes
• Avoid eating at least 3 hours before bedtime

Implementing these sleep strategies can help reduce nighttime reflux and improve overall sleep quality. Are you experiencing frequent nighttime heartburn? Try adjusting your sleep position and pre-bed routine to see if it makes a difference.

Stress Management Techniques for Heartburn Relief

Stress can exacerbate acid reflux symptoms and contribute to heart health issues. Incorporating stress-reduction techniques into your daily routine can help manage both conditions:

• Practice mindfulness meditation
• Engage in regular physical activity
• Try deep breathing exercises
• Consider yoga or tai chi
• Maintain social connections and hobbies
• Seek professional help if stress becomes overwhelming

Finding effective stress management strategies can improve both your digestive and cardiovascular health. Which stress-reduction techniques have you found most helpful in managing your symptoms?

By understanding the differences between heartburn and heart attack symptoms, making lifestyle adjustments, and working closely with healthcare providers, individuals can effectively manage acid reflux while staying vigilant about potential cardiac issues. Remember, when in doubt about chest pain or discomfort, it’s always better to err on the side of caution and seek medical attention promptly.

Telling the difference between heartburn and heart attack

Heart and VascularDecember 22, 2022

By Claudia Coons(SACRAMENTO)

Perhaps you just sat down to enjoy another slice of pie after a holiday meal and you feel a painful sensation in the center of your chest. Could it be heartburn flaring up? Or something more serious?

Acid reflux, commonly known as heartburn, is often mistaken for a heart attack.

While heart attacks are a life-threatening medical emergency, heartburn is not.

Recognizing the difference between cardiac and noncardiac chest pain is critical. Health Sciences Assistant Clinical Professor Jeffrey Ko discusses the symptoms of acid reflux, indigestion and heart attacks, and shares tips on how to prevent or minimize them.

What is indigestion?

Indigestion is pain or discomfort in the stomach associated with difficulty digesting food and feeling too full. Indigestion can cause acid reflux, which can cause pain in the esophagus just behind the breastbone. Due to the location of the pain, it is often mistaken for a heart attack.

With acid reflux, symptoms may include pain that spreads up to the throat but not to the extremities. The pain worsens when bending over or lying down. In addition, you may sense a bitter or acidic taste in the back of the throat. And, of course, some acid reflux symptoms typically appear after a large or spicy meal.

What foods can trigger acid reflux?

Acid reflux is quite common in adults during the holidays – especially because of all the seasonal foods.

“It’s a lot of things that we like, unfortunately: Coffee, black tea, alcohol, also fatty foods like what we eat for traditional holiday dinners,” explained Ko. “Also, common things we put in all our food like garlic and onion, even dark chocolate and mint can make acid reflux worse.”

How can we lessen the likelihood of indigestion?

Even if you are wanting to look your holiday best, steer clear of tight-fitting clothing. This can further compress the stomach and push acid up into the esophagus and cause discomfort.

Also, avoid eating close to bedtime and try to resist the urge to overeat, as this will also increase the likelihood of indigestion symptoms.

Lying flat in bed can also prompt acid reflux. It is best to sleep elevated with a couple pillows, or sleep on your side on nights when you’re feeling digestive discomfort

Heart attacks are more commonly missed in women and usually manifest as nausea and vomiting in women, more so than men. If you’re a woman over the age of 50, with other contributing factors such as diabetes or obesity and having these symptoms, it is advisable to go to the closest emergency room.” —Jeffrey Ko

What are symptoms of a heart attack?

Most heart attack patients describe shortness of breath and extreme pressure, like an elephant is sitting on their chest. This is usually accompanied by pain that starts in the chest and radiates to one or both arms and up to the shoulders and jaw, particularly on the left side.

Women’s heart attack symptoms may differ. In fact, almost 40 percent of women who have heart attacks reported experiencing symptoms similar to heartburn or indigestion shortly before their heart attacks.

“Heart attacks are more commonly missed in women and usually manifest as nausea and vomiting in women, more so than men,” Ko said. “If you’re a woman over the age of 50, with other contributing factors such as diabetes or obesity and having these symptoms, it is advisable to go to the closest emergency room.”

If you think you may be having a heart attack, don’t hesitate to call 911 or have someone call for you. You might also consider having someone immediately drive you to the nearest emergency department.

Heartburn (Acid Reflux) Symptoms – Burning, Pain, Difficulty Swallowing, and Cough

Written by WebMD Editorial Contributors

• Common Symptoms of Heartburn
• Heartburn vs. Heart Attack Symptoms
• Emergency Symptoms

If you’ve got a burning feeling in your chest just behind your breastbone that starts after you eat, it might be heartburn. The symptoms could last from a few minutes to several hours.

Heartburn begins when stomach acid splashes up into your esophagus, a tube that connects the back of your throat and stomach. Besides the burning feeling in your chest, you may also get:

• Chest pain, especially after you bend over, lie down, or eat
• Burning at the back of your throat
• Fluid at the back of your throat that tastes hot, sour, acidic, or salty
• Long-term cough, sore throat, or hoarseness

Telling your doctor about these symptoms is usually all they need to make a diagnosis of heartburn. But they may ask you to take special tests to find out how severe the problem is or to keep an eye on your treatment.

Chest pain is one of the most common reasons to go to the emergency room. While many of these people are having angina or a heart attack, some folks may have severe heartburn.

Often, the pain from angina, a heart attack, or a severe heartburn episode are so hard to tell apart that doctors need sophisticated tests to figure out what’s going on.

To complicate things even more, angina/heart disease and heartburn share risk factors of being older or overweight.

Signs more typical of heartburn include:

• You have a sharp, burning feeling just below your breastbone or ribs.The chest pain can be accompanied by an acidic taste in your mouth, regurgitation of food, or a burning in your throat.
• Pain generally doesn’t spread to your shoulders, neck, or arms, but it can.
• Pain usually comes after meals, particularly after foods or drinks that trigger reflux in you.
• Pain also comes when you lie down or exercise on a full stomach.
• Symptoms usually get better quickly after taking an antacid.
• You rarely get a cold sweat or shortness of breath along with your other symptoms.

If you have pain in your chest that’s not going away and you’re not sure whether it’s heartburn or a heart attack, call 911.

But don’t forget, the symptoms of heart attack and heartburn can sometimes go away after a while. So always call your doctor if you had pain in your chest and you’re not sure why — even if it stopped.

Also, call 911 if you have symptoms that are more typical of a heart attack or angina (severe chest pain from heart problems), such as:

• Feeling of fullness, tightness, or dull pressure or pain generally in the center of your chest
• Feeling like a belt is being tightened around your chest
• Pain that comes on with exercise, and is relieved by rest
• Sudden chest pain or pressure that gets worse
• Dizziness or lightheadedness
• Pain that spreads to your shoulders, neck, jaw, or arms
• Pain that gets better quickly after taking nitroglycerin
• Shortness of breath
• Cold sweat along with other symptoms

If you have any pain that lasts for more than a few minutes or any warning signs of a heart attack, get medical help right away. Also get emergency help if you’re confused at all about whether your symptoms are from a heartburn or a heart attack.

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11 September

Heartburn – the causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Heartburn is a feeling of burning, heaviness or pain behind the sternum. This condition significantly impairs the quality of life, reduces performance, disturbs sleep.

What diseases cause heartburn?

Heartburn can have a variety of causes that need to be identified in order to be diagnosed and treated.

Gastroesophageal reflux disease

This disease is accompanied by reflux (reflux) of the contents of the stomach into the esophagus, the walls of which are more sensitive to acidic irritants than the gastric mucosa.

Gastroesophageal reflux disease is quite common in the adult population and, if left untreated, can lead to persistent narrowing of the esophagus, bleeding, and ulcers.

The basis of the development of the disease is a violation of motility, or dyskinesia of the gastrointestinal tract. First of all, this is a dysfunction of the lower esophageal sphincter and a violation of the peristalsis of the esophagus. Periodic uncontrolled relaxation of the lower esophageal sphincter leads to the entry of stomach contents into the esophagus, which can be exacerbated by esophageal hernia, which increases the frequency of reflux.

Hiatal hernia also causes heartburn. In this case, it may be accompanied by belching, reflux of the contents of the stomach into the oral cavity. Pain that occurs in the lower part of the sternum may radiate to the back, to the left shoulder and left arm, as with angina pectoris. Pain or burning sensation often occurs when lying down, when bending forward, after eating, i.e. when intra-abdominal pressure rises.

Peptic ulcer of the stomach. Heartburn in gastric ulcer may occur due to increased production of hydrochloric acid in the stomach and its reflux into the esophagus, especially at night. This condition is called a nocturnal acid breakthrough, and it seriously aggravates the condition, causing pain and burning in the chest and disturbing sleep.

Cancer of the cardia of the stomach.

In this disease, heartburn may be the dominant symptom.

First, there is a burning sensation and “scratching” when food passes through the esophagus. Then there is difficulty in swallowing, pain behind the sternum, often radiating to the region of the heart.

Hypersensitive esophagus.

Heartburn can be a symptom of hypersensitivity of the lining of the esophagus.

This individual feature can be explained by an increased perception of pain by the esophageal receptors, a violation of the integrity and increased permeability of the mucous membrane, a violation of the perception and processing of incoming signals in the central nervous system.

Functional heartburn. This concept has appeared relatively recently and refers to heartburn, which excludes gastroesophageal reflux disease, structural and motor disorders of the esophagus. The mechanisms for the development of such heartburn are not yet clear and can be explained both by the increased sensitivity of the esophagus and by the characteristics of the nervous system. At the same time, there is no connection between heartburn and diseases of the esophagus and motility of the gastrointestinal tract.

Other possible causes

Functional dyspepsia

Under functional dyspepsia, conditions are combined that are caused by a temporary disruption of the activity of the stomach, duodenum and pancreas.

The causes of the disease are violations of gastric secretion, motility of the gastrointestinal tract, increased sensitivity of the mucous membrane. Complaints of patients with dyspepsia include: pain or discomfort in the epigastric region, heaviness, a feeling of fullness after taking the usual amount of food, bloating, diarrhea, nausea, vomiting, belching, heartburn. Various toxic infections can also provoke functional dyspepsia. An important role in the occurrence of the disease belongs to psychosomatic disorders. Patients with functional dyspepsia are often characterized by anxiety. Given that the symptoms of the disease may disappear after taking antacids, doctors often note the leading role of the acid factor, which triggers the pathological process. When examining such patients, it is often not possible to detect organic diseases (ulcers, tumors or pancreatitis).

Taking medications. This is a fairly common cause of heartburn. In this case, such a symptom is caused by drugs that reduce the tone of the lower esophageal sphincter: non-steroidal anti-inflammatory drugs, glucocorticosteroids, calcium antagonists, beta-blockers, anticholinergics, theophylline, progesterone, antidepressants, nitrates, doxycycline, quinidine.

Conditions accompanied by increased intra-abdominal pressure. These conditions include pregnancy, enlarged liver, spleen, chronic obstructive pulmonary disease. The result is a change in the position of the stomach and easier entry of its contents into the esophagus.

Which doctors should I contact?

Heartburn can be a sign of a serious illness, so self-medication with prolonged and repeated manifestations of it is unacceptable.

If heartburn occurs at least twice a week, it is imperative to visit
therapist or
gastroenterologist to get a referral for examination of the gastrointestinal tract. If a concomitant anxiety-depressive state is detected, a psychoneurologist’s consultation is necessary.

Diagnostics and examinations

As a rule, upon presentation of complaints of heartburn observed for at least three months, the gastroenterologist interviews the patient about the time, frequency, provoking factors of heartburn. First of all, as with other diseases, the doctor prescribes a general blood test and a biochemical blood test.

If a disease of the esophagus is suspected, an endoscopic examination is prescribed to identify a possible hernia, neoplasm, and assess the condition of the mucous membrane.

You can also diagnose a narrowing (stricture) or expansion of the esophagus using x-ray, which allows you to see a violation of the passage of barium suspension into the stomach and expansion of the esophagus.

To rule out infection with Helicobacter pylori, a C-urease breath test is prescribed.

If the mucous membrane of the esophagus is unchanged and there is no hernia of the esophagus, the doctor may prescribe daily monitoring of the pH of the esophagus. Ultrasound will help to exclude tumors and diseases of the liver, gallbladder and pancreas.

To assess the contractile activity of the esophagus and the coordination of the work of its sphincters, esophageal manometry is performed.

Treatment

Heartburn is only a symptom of pathologies of the gastrointestinal tract, so its effective elimination is possible only in the treatment of the underlying disease.

If heartburn is caused by a stomach ulcer, gastroesophageal disease, a doctor may prescribe treatment with antacids, proton pump inhibitors or H2 blockers, prokinetics. The treatment regimen is determined only by the doctor.

Patients should be aware that taking antisecretory drugs without a doctor’s prescription can greatly worsen the prognosis of the disease and lead to the ineffectiveness of subsequent treatment.

Often the need for surgical intervention is caused by the unsystematic use of antacids or antisecretory drugs. In addition, heartburn can be caused not only by hydrochloric acid, but also by bile, which has a strong irritating effect.

If the examination reveals Helicobacter pylori infection, antibiotic therapy should be given to prevent stomach cancer.

In anxiety-depressive conditions, a psychotherapist or neuropsychiatrist supplements treatment with tricyclic antidepressants, selective serotonin reuptake inhibitors, and neuroleptics.

With the ineffectiveness of drug treatment and complications in the form of esophagitis, impaired patency of the esophagus, deformities of the stomach, they resort to surgical intervention.

What should be done when symptoms appear?

First of all, it is desirable to switch to fractional nutrition, i.e., reduce the intervals between meals (no more than three hours) and reduce portions.

It is not recommended to eat very hot or cold dishes, food must be chewed thoroughly. Do not bend over or lie down immediately after eating. The last meal should be at least 3-4 hours before bedtime.

It is recommended to get rid of bad habits (smoking and drinking alcohol).

Since a significant role of neuropsychiatric disorders in the development of gastrointestinal diseases has been proven, the daily regimen should be stabilized, paying attention to health-improving physical activity.

The work of the gastrointestinal tract is closely related to daily biological rhythms, so it is very important to follow a diet.

Sources:

1. Clinical guidelines “Peptic ulcer of the stomach and/or duodenum” (children). Developed by: Union of Pediatricians of Russia, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy, Russian Association of Pediatric Surgeons, Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists. – 2021.
2. Clinical guidelines “Stomach cancer”. Developed by: Association of Oncologists of Russia, Russian Society of Clinical Oncology. – 2020.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes over time, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Doctors of the clinic “MedExpert” emphasize that heartburn cannot be tolerated!

What is heartburn?

Heartburn is a feeling of discomfort or burning behind the sternum, spreading upward from the epigastric region, sometimes extending to the neck. The main cause of heartburn is the intake of acidic stomach contents into the esophagus. Hydrochloric acid, which is in the stomach, is a very aggressive environment, but the gastric mucosa is reliable and protected from it, unlike the esophageal mucosa. She then suffers, there is a burning sensation and discomfort when acidic contents enter it.

What symptoms can accompany heartburn?

Heartburn is not a disease in itself, but is a symptom of other diseases or problems in the gastrointestinal tract. Therefore, see a doctor as soon as possible if the symptom of heartburn occurs more than once a week, its attacks become stronger, it is difficult to swallow, heartburn does not go away even after taking antacids.

What diseases can cause heartburn?

Insidious heartburn likes to hide behind a picture of other processes, confusing not only patients but also doctors.

For example, there have been cases of patients being brought to hospital with presumably myocardial infarction. In fact, as it turned out later, heartburn provoked pain. Often, burning pains in the chest area appear with other diseases.

It is important to know how they differ, so below we will consider what kind of diseases a burning sensation in the chest can be a symptom of.

Heartburn is the main symptom of GERD

Heartburn is the main symptom of gastroesophageal reflux disease (GERD). In 75% of people who suffer from frequent bouts of heartburn, the cause is GERD. This disease is characterized by the same symptoms as simple heartburn, but there are significant differences:

• • • with GERD, heartburn is constant, it is stopped by antacids for a short time;
    • in the morning there is a feeling of bitterness;
    • is characterized by rapid saturation with a small amount of food;
    • retrosternal pain along the esophagus, are pressing and compressive in nature, give up and to the left, increase during swallowing and appear after eating.

    When heartburn mimics angina pectoris

    The well-known angina is easily confused with heartburn. It creates pseudoangina. The main symptom is burning pain in the chest area radiating to the left arm, jaw, under the shoulder blade. But with angina pectoris, as it is customary to call angina pectoris in everyday life, pain often appears after emotional overstrain, with prolonged physical exertion. What else characterizes angina pectoris?

    • These symptoms disappear only after taking nitroglycerin.
    • It is important to do an electrocardiogram (ECG) and fibrogastroduodenoscopy (FGDS – examination of the upper gastrointestinal tract only) at the first signs.

    These absolutely painless examinations will help to dot the diagnosis. The absence of changes in the ECG during a pain attack can calm the doctor and the patient, ruling out coronary heart disease.

    Cough or heartburn?

    Heartburn tries on a “lung mask”, giving out all the same burning sensations in the chest for diseases of the respiratory system.