Heartburn or Heart Attack?

February 1, 2017 | By | Reply More


Pay attention to symptoms, seek help immediately if condition warrants

By Gordon L. Kritzer, MD, FACC
Cardiologists, Virginia Mason Hospital and Seattle Medical Center

Since large meals are often part of holiday celebrations, it is easy to over eat when celebrating Christmas, New Year’s, Valentine’s Day and other special occasions.

If, after eating a big meal, you feel a burning sensation in your chest, you might think it is heartburn, and it might be. However, there is a chance that the chest pain could be caused by reduced blood flow to your heart (angina) or an actual heart attack.

What is heartburn?

Heartburn, often called acid indigestion, is discomfort or actual pain caused by digestive acid moving into the esophagus, which carries swallowed food to your stomach.

Classic heartburn symptoms include:

  • A burning sensation starting in the upper abdomen and moving up into the chest
  • Usually occurs after eating or while lying down or bending over
  • May awaken you from sleep, especially if you have eaten within two hours of going to bed
  • Usually relieved by antacids
  • Might be accompanied by a sour taste in your mouth, especially when you are lying down
  • May be accompanied by a small amount of stomach contents rising up into the back of your throat (regurgitation)

Common confusion

Despite its name, heartburn is related to your esophagus, not your heart. But because the esophagus and heart are located near each other, either one can cause chest pain that sometimes radiates to your neck, throat or jaw. This is why many people mistake heartburn for angina and vice versa.

Since heartburn, angina and heart attack may feel very much alike, even experienced doctors cannot always tell the difference from your medical history and a physical exam. That is why if you go to an emergency department for chest pain, you will immediately have tests to rule out a heart attack.

What to do if you’re unsure

I often tell patients that if you burp and symptoms go away, it probably isn’t related to your heart, but to your esophagus. However, if you suddenly experience shortness of breath and sweating or persistent chest pain, then it’s likely a heart-related issue and you should call 911 immediately.

Also, call your doctor if you had an episode of unexplained chest pain that went away within a few hours and did not seek medical attention. This is important because both heartburn and a developing heart attack can cause symptoms that subside after a while. The pain does not have to last a long time for it to be a warning sign.

Heart attack vs. sudden cardiac arrest

It is also important that people are able to recognize the difference between a heart attack and sudden cardiac arrest. When someone is having a heart attack, he or she is conscious and might complain of chest pain or other symptoms.

When a person is experiencing sudden cardiac arrest, the heart has unexpectedly stopped beating and blood is no longer pumping throughout the body or brain. The individual may lose consciousness and appear lifeless. Some victims gasp and shake as if they are having a seizure. Death can occur within minutes.

If someone is experiencing heart trouble

If someone is experiencing heart trouble, here are the five things you should do right away before help arrives:

1. Call 911

Whether it is a heart attack or sudden cardiac arrest, step one is always to call 911 to report the emergency and allow emergency dispatchers to coach you through some simple, potentially lifesaving steps.

2. Ease strain on the heart

If the person is conscious and possibly suffering a heart attack, help move the person into a comfortable position – half-sitting, with head and shoulders well supported and knees bent, to ease strain on the heart. Also, loosen clothing at the neck, chest and waist.

3. Chew and swallow an aspirin

If the person is conscious, give them a full dose (300 mg) of aspirin. Have the person chew it slowly so it dissolves and is absorbed into the bloodstream more quickly when it reaches the stomach. Aspirin helps break down blood clots, minimizing muscle damage during a heart attack.

4. Perform cardiopulmonary resuscitation (CPR)

If the person is unconscious, the next step is to start chest compressions. To do this, press hard (about two inches deep) and fast (100-120 times per minute) on the center of the chest.

5. Look for an automated external defibrillator

These commonly found devices have clear instructions and are designed for use by the public. To use one, simply attach the pads as indicated on the machine, then it will talk you through the process. It will only deliver a shock if the patient’s condition warrants. Leave the machine switched on at all times, and leave the pads attached – even if the patient has recovered.

Awareness is key

Whether wondering if it is heartburn vs. heart attack or heart attack vs. sudden cardiac arrest, being able to recognize symptoms and act quickly is key. After all, knowledge is power and without it, we cannot be our – or someone else’s – own best health advocate.

Cheers to your health!

Gordon L. Kritzer, MD, FACC, is a board certified cardiologist who specializes in interventional and invasive cardiology as well as cardiac rehabilitation. He practices at Virginia Mason Hospital and Seattle Medical Center (206-341-1111).

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Category: Emergency Medicine, Heart, Virginia Mason

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