Heartburn vs. Heart Attack: How to Tell the Difference
Understand the symptoms, differences, and risks to distinguish heartburn from a heart attack and know when to seek urgent help.
Experiencing chest pain can be alarming, especially since both heartburn and heart attack can share some symptoms. Understanding the difference is crucial, as one may be resolved with an over-the-counter remedy, while the other is a life-threatening emergency. This article explores the signs, causes, distinctions, and proper responses for heartburn and heart attack.
Contents
- Overview of Heartburn and Heart Attack
- Symptoms: Comparing Heartburn and Heart Attack
- Causes and Risk Factors
- When to Seek Emergency Help
- Diagnosis
- Treatment Options
- Prevention Tips
- Frequently Asked Questions (FAQs)
Overview
Heartburn and heart attack are two different conditions that may both cause chest pain. While heartburn is related to digestive issues caused by acid reflux, a heart attack is a cardiovascular emergency caused by blocked blood flow to the heart muscle. Understanding the unique features and warning signs can prevent delays in care and potentially save a life.
Symptoms: Comparing Heartburn and Heart Attack
| Symptom | Heartburn | Heart Attack |
|---|---|---|
| Chest pain | Burning sensation, often behind breastbone; may rise toward throat | Pressure, tightness, squeezing, or aching; often in center or left chest, may radiate |
| Pain radiation | Can move to throat, neck, or jaw | May radiate to arms (especially left), neck, back, jaw, or stomach |
| Associated digestive symptoms | Acidic taste, regurgitation, nausea, bloating, belching | Nausea, vomiting, indigestion-like pain occasionally present |
| Other symptoms | Usually no sweating, dizziness, or severe fatigue | Shortness of breath, cold sweat, lightheadedness, extreme fatigue possible |
| Trigger | Often after meals or lying down, eating spicy or acidic foods | May occur with physical exertion, stress, or spontaneously—typically not meal-related |
| Response to antacids | Usually improves with antacids | Usually does not improve with antacids |
Key Symptoms of Heartburn
- Burning chest pain or discomfort, often just behind the breastbone
- Pain may move upward toward the neck or throat
- Sour or acidic taste in the mouth
- Regurgitation of food or sour liquid
- Bloating, burping, or nausea
- Symptoms often worse after eating, lying down, or bending over
Key Symptoms of Heart Attack
- Chest pain, pressure, or tightness that may spread to arms, neck, jaw, or back
- Shortness of breath
- Cold sweat
- Nausea or vomiting
- Dizziness or lightheadedness
- Fatigue or a sense of impending doom
- Pain may worsen with activity or stress, not necessarily with food
Special note about women:
- Women often experience less typical symptoms such as jaw, neck, shoulder, back pain, nausea, or lightheadedness
Distinguishing Features
- Heartburn: Burning pain, linked to meals or position, improved with antacids
- Heart Attack: Pressure, squeezing, radiating pain, not related to meals, often with sweating or breathlessness, does not improve with antacids
Causes and Risk Factors
Heartburn (Acid Reflux)
- Stomach acid flows back into the esophagus
- Triggered by certain foods: spicy dishes, citrus, chocolate, fatty meals, caffeine, alcohol
- Lying down soon after eating increases risk
- Risk factors include obesity, pregnancy, smoking, hiatal hernia, and overeating
- Frequent heartburn could be due to gastroesophageal reflux disease (GERD)
What others are reading
Heart Attack (Myocardial Infarction)
- Blocked or reduced blood flow to part of the heart muscle
- Most often caused by buildup of fatty plaques (atherosclerosis) or a blood clot
- Risks increase with age, family history, high blood pressure, high cholesterol, diabetes, smoking, obesity, sedentary lifestyle
- Triggers include physical activity, stress, or even rest (in severe cases)
When to Seek Emergency Help
Never ignore chest pain, pressure, or discomfort—especially if it is severe, new, or accompanied by:
- Shortness of breath
- Pain radiating to neck, jaw, arms, or back
- Cold sweats, nausea, or vomiting
- Lightheadedness or fainting
- Severe anxiety or impending sense of doom
If you are unsure whether your symptoms are heartburn or a heart attack, call emergency services (911) immediately. Quick response saves lives in case of a heart attack.
Other Causes of Chest Pain
- Esophageal spasm
- Gallbladder disease
- Anxiety or panic attacks
- Muscle or rib injuries
Regardless of the cause, chest pain deserves prompt attention if you cannot confidently link it to a benign trigger like indigestion.
Diagnosis
How Doctors Distinguish Between Heartburn and Heart Attack
- Medical history and risk assessment
- Physical exam
- Electrocardiogram (ECG/EKG) to evaluate heart function
- Blood tests for markers of heart muscle injury (e.g., troponin)
- Imaging such as chest X-ray or echocardiography if warranted
- If heart problems are excluded, focus shifts to digestive testing for acid reflux or esophageal disorders
Doctors may recommend a stress test, endoscopy, or pH monitoring if digestive issues are suspected.
Treatment Options
Heartburn
- Over-the-counter antacids for immediate relief
- Acid reducers (H2 blockers, proton pump inhibitors) for frequent symptoms
- Dietary and lifestyle modifications (see prevention tips below)
- Treatment of underlying GERD if present
Heart Attack
- Immediate emergency care, often including aspirin, nitroglycerin, oxygen
- Hospital treatments such as clot-busting drugs, angioplasty, or surgery
- Cardiac monitoring and long-term management to prevent future events
Never attempt to self-treat chest pain that could be a heart attack.
Prevention Tips
Preventing Heartburn
- Avoid trigger foods (spicy, fatty, or acidic foods and drinks)
- Eat smaller meals and don’t lie down right after eating
- Elevate your head while sleeping
- Maintain a healthy body weight
- Stop smoking and reduce alcohol intake
- Manage stress, as it can exacerbate digestive symptoms
Preventing Heart Attack
- Control risk factors: manage blood pressure, cholesterol, and diabetes
- Eat a heart-healthy diet
- Be physically active regularly
- Avoid tobacco products and limit alcohol
- Monitor and address family history and regular check-ups
Frequently Asked Questions (FAQs)
Q: Can heartburn feel exactly like a heart attack?
A: Heartburn can sometimes closely mimic heart attack pain, especially if it causes significant burning or pressure in the chest. If chest pain is new, severe, or you aren’t sure, seek emergency care immediately, as only a thorough medical evaluation can rule out a heart attack.
Q: How can I tell the difference at home?
A: Heartburn usually follows meals, feels like burning, and may improve with antacids. Heart attack pain is often pressure-like, not related to food, may be accompanied by sweating, nausea, or shortness of breath, and doesn’t improve with antacids. When in doubt, seek help.
Q: Are women’s heart attack symptoms different from men’s?
A: Yes, women often have less typical symptoms, including back, jaw, or neck pain, nausea, unusual fatigue, or shortness of breath—even without classic chest pain. This makes prompt medical assessment critical in women with suspicious symptoms.
Q: Can stress cause either heartburn or heart attack?
A: Stress can worsen both conditions. It may trigger acid reflux leading to heartburn and also act as a precipitating factor for a heart attack, particularly in people with existing heart disease risk factors.
Q: What else can cause chest pain?
A: Other causes include esophageal spasm, gallbladder disease, anxiety, muscle pain, or pneumonia. Because causes are varied and some are serious, new or unexplained chest pain should be evaluated by a healthcare provider.
Q: When should I see a doctor about heartburn?
A: See a doctor if heartburn is frequent (multiple times per week), persistent despite medications, causes difficulty swallowing, or if you have weight loss, vomiting, or blood in stool. These can indicate more serious conditions.
Key Takeaways
- Heartburn is a burning chest sensation caused by stomach acid; it is unpleasant but rarely life-threatening.
- Heart attack is caused by lack of blood flow to the heart muscle, requiring immediate emergency treatment.
- Persistent, severe, or unusual chest pain should always be evaluated promptly to rule out a heart attack.
- If in doubt, call emergency services right away—it’s better to be safe.
References
- https://www.hcahoustonhealthcare.com/healthy-living/blog/is-it-heartburn-or-heart-attack
- https://www.mayoclinic.org/diseases-conditions/heartburn/in-depth/heartburn-gerd/art-20046483
- https://www.medicalnewstoday.com/articles/312964
- https://www.massgeneralbrigham.org/en/about/newsroom/articles/heartburn-vs-heart-attack-how-to-tell-the-difference
- https://www.houstonmethodist.org/blog/articles/2025/apr/heartburn-or-heart-attack-signs-of-both-how-to-tell-the-difference/
- https://www.health.harvard.edu/heart-health/heartburn-vs-heart-attack
- https://health.ucdavis.edu/news/features/telling-the-difference-between-heartburn-and-heart-attack/2022/12
- https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/heartburn-or-heart-attack
- https://hartfordhealthcare.org/about-us/news-press/news-detail?articleId=59699
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