Symptoms of Gastroesophageal Reflux vs. Heart Attack

Is it heartburn signaling acid reflux or a heart attack?

Photo by Tom Le Goff (Getty Images)
Photo by Tom Le Goff (Getty Images)

Asking "what does acid reflux or heartburn feel like?" seems like a simple enough question. Usually, heartburn is said to feel like some level of discomfort in the chest area. Heartburn or acid reflux is a symptom of gastroesophageal reflux disease (GERD), but it's typically not the only one. Also, some people who experience gastroesophageal reflux won't ever have chest discomfort.

Acid Reflux and Heartburn Symptoms

Heartburn is not the same for everyone who experiences it.

What you feel when you have an episode of heartburn may not be in the same area of the body, or of the same intensity, as what someone else feels. These are some of the possible ways heartburn can make you feel.

  • A burning sensation or pain in the chest: This is the symptom most often thought of in association with heartburn. This burning sensation usually starts behind the breastbone (the sternum), and will sometimes travel up to the throat. It's usually first noticed shortly after eating.
  • A burning feeling in the throat: This burning sensation is usually felt high up in the neck (though it can occur lower) and may worsen with swallowing. It is due to the acid from the stomach contents.
  • Sour or bitter taste in the mouth:   Partially digested food and stomach acid can reflux into the esophagus and reach the back of your throat.
  • Difficulty swallowing: This symptom should always be evaluated by a physician as it may be a sign of a serious disorder, not simply heartburn. You may feel as if food is sticking in your throat, chest pressure after eating, or a feeling of choking.  This is also called dysphagia. It occurs when food does not pass unrestricted from the mouth through the esophagus to the stomach. It could be a sign of erosive esophagitis and esophageal cancer.
  • Chronic coughing: If stomach acids reflux back into the esophagus and are aspirated, coughing can occur. Many cases of a chronic cough are due to GERD.
  • Wheezing or other asthma-like symptoms: GERD can affect asthma when stomach acid leaks back into the esophagus and is aspirated into the airways and lungs, which can make breathing difficult and cause you to wheeze and cough.There are studies that suggest a significant link between GERD and asthma.

    Is Your Chest Pain Heartburn or a Heart Attack?

    How can you tell if your chest pain is caused by heartburn or a heart attack? Sometimes it's difficult to distinguish the two, so if there is any confusion as to whether you are suffering from a bout of heartburn or are having a heart attack, you need to seek immediate medical attention.

    Symptoms more typical of the chest pain caused by heartburn include:

    • A burning sensation or pain that occurs just below the breastbone
    • This pain rarely radiates to the shoulders, neck, or arms, though it does occur on occasion
    • This pain usually comes after meals, or when lying down soon after eating
    • This chest pain usually responds quickly to antacids
    • The pain is rarely accompanied by a cold sweat

    Symptoms more typical of a heart attack include:

    • The feeling of fullness, tightness, pressure, or pain in the center of the chest
    • There may be a squeezing sensation as if something was tightening around the chest
    • Dizziness
    • Pain may spread to the shoulders, neck, jaw or arms
    • Nausea
    • Fatigue
    • Shortness of breath
    • Cold sweat
    • Lightheadedness
    • Weakness

    Again, if there is any confusion about whether your symptoms are related to heartburn or are the warning signs of a heart attack, you should seek immediate medical attention.

    Heartburn is not a disorder by itself. It is, however, a symptom of another digestive disorder. For example, heartburn is the most common symptom of gastroesophageal reflux disease.

    Sources:

    Symptoms & Causes of GER & GERD. National Institute of Diabetes Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes.

    Fanaroff AC, Rymer JA, Goldstein SA, et al. Does This Patient With Chest Pain Have Acute Coronary Syndrome?: The Rational Clinical Examination Systematic Review. JAMA 2015; 314:1955.

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