Heartburn or Heart Attack?

By Stacey Colino

Is it heartburn or a heart attack? Because they both involve chest pain, it can be difficult to tell the difference. But heartburn and heart disease occupy such dramatically different positions on the severity spectrum that figuring out what’s really happening in your body could mean the difference between life and death. To help you distinguish one from the other, consider these key factors:

Type of pain
Heart attacks generally cause pain, pressure or a squeezing sensation in the chest. The pain may also radiate into the neck, jaw, shoulder, arms or back. While heartburn can mimic all these sensations, “the most common symptom of heartburn is a burning pain right behind the breastbone,” says Dr. Marie Borum, professor of medicine and director of the division of gastroenterology and liver disease at George Washington University in Washington, D.C.

Timing
Heartburn often occurs right after a meal. “When your stomach is full, there’s more of an opportunity for stomach contents to wash back up into the esophagus,” explains Borum. Heart-related symptoms, on the other hand, are more likely to occur during exercise, other physical exertion or possibly emotional upset.

Duration
Discomfort from heartburn can last from minutes to hours, but it tends to resolve spontaneously or go away after you take antacids, says Borum. Heart attacks, on the other hand, do not go away by themselves. What’s more, if you’re having a heart attack, every second counts; there’s no time to wait and see what happens. So if there’s any doubt in your mind about what’s causing your chest pain, call 911 or your doctor.

Other symptoms
In addition to chest pain, chronic heartburn can cause hoarseness, sore throat, cough, difficulty swallowing or a sensation that something is caught in the back of your throat. Meanwhile, heart attack may be accompanied by weakness, lightheadedness, dizziness, fainting, shortness of breath, nausea and/or a cold sweat.

While it can be helpful to understand the features that distinguish heartburn from heart attack, if you’re not sure what’s causing your chest discomfort, don’t waste time trying to diagnose yourself. Heart attacks require immediate medical attention. If there’s any chance you might be having one, call 911 pronto!

Stacey Colino has written for The Washington Post health section and many national magazines, including Newsweek, Real Simple, Woman's Day, Self, Marie Claire, Cosmopolitan, Glamour, Parenting, Sports Illustrated and Ladies' Home Journal.

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