You have pain that starts in your chest and moves up your throat. You want to assume it’s heartburn but the worry about a heart attack is in the back of your mind. It is not unusual for people to mistake symptoms of heart disease for heartburn. Many people have also gone to the emergency room out of fear of a heart attack, only to find out it was severe heartburn. In truth, the symptoms can be very similar. In fact, it often takes medical testing to determine the true cause.
Pain May Be Difficult to Distinguish
Here are some facts that may help.
Possible Signs of Heartburn
- A sharp, burning sensation below the breastbone or ribs
- Burning sensation may move up toward the throat
- Pain often occurs after eating, particularly when lying down
- Pain increases when bending over, lying down, exercising, or lifting heavy objects
- Bitter or sour taste at the back of the throat
- Symptoms respond quickly to antacids
Note: Call for emergency medical services right away if you have any chest pain. Even if you think it may be heartburn.
Possible Signs of Angina or Heart Attack
- A feeling of uncomfortable fullness, pressure, squeezing, tightness, or pain in the center of the chest (may last for more than a few minutes or goes away and comes back)
- Physical exertion or emotional stress triggered problems
- Pain or discomfort spreads to one or both arms, the back, stomach, neck, or jaw
- Shortness of breath
Other symptoms may include:
- Breaking out in a cold sweat
- Rapid heartbeat
Other Causes of Chest Pain
Heartburn and heart attacks are not the only conditions that can cause chest pain. Other problems that can cause chest pain include:
Other heart conditions, such as:
- Coronary spasm—arteries to the heart spasm, temporarily limiting blood flow to the heart muscle
- Pericarditis—inflammation of the sac surrounding the heart
- Aortic dissection—rare, but dangerous condition in which the inner layers of the aorta separate
- Damage or irritation to tissue of the chest wall such as:
- Lung conditions, such as:
- Panic attack—periods of intense fear accompanied by anxiety, chest tightness, rapid heartbeat, rapid breathing, profuse sweating, and shortness of breath
- Shingles —infection of a nerve root, caused by reactivation of the chickenpox virus
- Gallbladder or pancreas problems—gallstones or inflammation of the gallbladder or pancreas can cause abdominal pain, which can radiate to the chest
- Disorders of the esophagus—swallowing disorders such as esophageal spasms and achalasia (failure of esophageal muscle to relax)
- Cancer —cancer involving the chest or that has spread from another part of the body
Seeking Medical Attention for Chest Pain
It can be hard to determine the cause of chest pain. Call for emergency medical services right away if you have any chest pain. Especially if you have other signs and symptoms of a heart attack.
Do not have someone drive you to the hospital. Emergency medical crews can provide treatment on the way to the hospital. The sooner treatment is given the better the outcomes for heart attacks.
The American College of Gastroenterology
American Heart Association
Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada
Gastroesophageal reflux disease (GERD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 11, 2016. Accessed May 10, 2016.
Heart attack. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/Heart-Attack_UCM_001092_SubHomePage.jsp. Accessed May 10, 2016.
Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerd. Accessed May 10, 2016.
ST-elevation myocardial infarction (STEMI). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 5, 2016. Accessed May 10, 2016.
Last reviewed May 2018 by Michael Woods, MD Last Updated: 7/21/2018