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Heart attack vs. heartburn: How to tell them apart

Heart attack vs. reflux

Several years ago while at work at Via Christi, I felt like I was experiencing the common symptoms of a heart attack: tightness and the feeling of someone sitting on my chest and a feeling of numbness in my left arm.

I went to the Emergency Room and was immediately taken care of. The ER staff was somewhat baffled by the results of the tests they gave me. My blood work came back normal, not producing the “typical” indicators of heart muscle damage – but my electrocardiogram indicated something was going on. After a treadmill nuclear stress test where they inject dye into your veins to “light-up” damaged, or clogged areas of the heart muscle, I was cleared of all heart issues.

Because I was still having chest pains, I was referred to a gastroenterologist for an upper endoscopy, where you are given anesthesia, and a camera is threaded down your throat, into your esophagus, stomach, and first part of the small intestine.

The results indicated that a hiatal hernia was the culprit of my chest pains. This is a condition where part of the stomach sticks up into the chest through an opening in the diaphragm.

I was also diagnosed with recurring Gastro esophageal Reflux Disease (GERD) symptoms, which occur when the return of the stomach's contents back up into the esophagus causing the more common day-to-day symptoms of heartburn.

The combination of the hiatal hernia and GERD was causing muscle spasms in the esophagus, which felt like chest pains similar to that of a heart attack. Once I was placed on typical GERD medications, all my chest pains went away.

Similar symptoms

Ali Elkharbotly, MD, a Via Christi cardiologist, says it's fairly common for heart attack symptoms and GERD to be similar.

“It can be difficult to tell the difference between a heart attack and heartburn because some people have atypical symptoms of a heart attack which can be confused for heartburn,” Dr. Elkharbotly says.

Dr. Elkharbotly explained that the most common symptoms of a heart attack are usually pain in the left side of the chest accompanied with the feeling of extreme pressure on the chest. There can also be pain in the left arm and some numbness; even pain in the jaw. These symptoms typically last 15 to 20 minutes and continue for an extended period of time.

There also are times when people can present with atypical symptoms such as pain in the middle of the chest, a burning sensation in the chest, nausea and vomiting. Diabetics and women often present with atypical symptoms.

Better safe than sorry

When you’re having these symptoms, it’s important to pay attention to the severity of the pain and what brings your symptoms on and what stops them. If the pain only lasts for a few seconds and goes away, that’s usually muscle or bone related. There are many things in the chest that can cause pain such as bone, nerves, lung tissue and the heart.

The typical heartburn pain happens after eating something acidic or spicy and can be accompanied by a burning sensation in the chest and a metallic taste in the mouth.

“Unfortunately we are all different and symptoms are perceived differently among people,” Dr. Elkharbotly says. “That’s why we depend on medical tests to help us definitively diagnose a heart attack.”

The best advice if you think you’re not sure if you might be having a heart attack: Seek medical attention as soon as possible. It’s better to be safe than sorry.

About Phil Omenski