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Chest pain can be scary — especially if you don’t know what it means. When it comes to heartburn vs. a heart attack, the symptoms can be surprisingly similar, which makes it hard to tell them apart. So how can you know the difference?
Columbus Batiste, MD, an interventional cardiologist and regional chief of cardiology for Kaiser Permanente in Southern California, breaks down the signs that set heart attacks apart from heartburn. Plus, find out when to see a doctor.
What is heartburn?
Heartburn is discomfort or pain that occurs when food and stomach acid back up into the esophagus — the tube that leads from the throat to the stomach. It can last from a few minutes to several hours.
Common signs include:
- A burning sensation in the chest or stomach
- Foul breath and a sour, acidic, or metallic taste in the mouth
- More gas or belching than usual
- Coughing, especially when lying down
- Symptoms that start after eating or lying down
An antacid should help relieve your symptoms. You can also try drinking a glass of water with a spoonful of baking soda stirred in. Is heartburn keeping you from sleeping? Propping yourself up in bed can help.
When should I get medical help? Contact your doctor for advice if:
- An antacid doesn’t temporarily ease your symptoms
- This is the first time you’ve had heartburn
- Your symptoms have changed
Risk factors for heart disease
Heartburn or heartburn-like symptoms could be serious if you’re prone to heart disease. Risk factors include:
- High blood pressure
- High cholesterol
- Diabetes or prediabetes
- Smoking
- A family history of heart disease at a young age.
When should I get medical help? If you’re suffering from persistent heartburn and have one or more of these risk factors, get medical attention right away.
What are the signs of a heart attack?
A heart attack can happen anytime. It can occur randomly or after physical or emotional stress. And it can last for several minutes or longer. Chest discomfort that goes away in seconds is almost never from a heart attack. Most people can feel the well-known warning signs of a heart attack. These are the symptoms you see in movies and TV shows, like:
- Pain, tightness, or pressure in the chest
- Discomfort traveling to the arm, neck, or jaw
- Shortness of breath
- Sweating
But for women, “absolutely nothing is typical in terms of heart attack symptoms,” Dr. Batiste says. Warning signs for heart attacks in women could be a general unwell feeling or a few milder symptoms, like:
- Nausea
- Shortness of breath
- Fatigue
- Back discomfort
- Lightheadedness
When should I get medical help? If you have chest pain or think you’re having a heart attack, call 911 or go to the nearest hospital.1
"Silent" heart attacks are common
More than 1 in 5 heart attacks appear to have no symptoms.2 And these so-called silent heart attacks can be just as serious, says Dr. Batiste. So, is heartburn a sign of a heart attack — even a silent one? It could be.
When should I get medical help? If you have ongoing heartburn with other constant symptoms like fatigue and shortness of breath, get immediate medical attention. Especially if you are at risk for heart disease.
Another cause of chest pain
Angina is a feeling of pressure or tightness in the middle of the chest. It happens when blood flow to the heart decreases, sometimes due to stress. The pain can feel like heartburn and usually lasts between 2 and 20 minutes. It tends to be milder and shorter than a heart attack and often stops if you rest or quit the activity that triggered it. If you’re feeling these symptoms for the first time, seek immediate medical attention.
When should I get medical help? If you're feeling these symptoms for the first time, seek immediate medical attention
Learn more about cardiac care at Kaiser Permanente.