Heartburn or Heart Attack? Signs of Both & How to Tell the Difference

When chest discomfort accompanies symptoms such as burning and nausea, it's natural to be worried. For most people these are signs of heartburn, the uncomfortable flow of stomach acid back up into the esophagus. But for some, these are signs of a heart attack that could be fatal if dismissed.

"If you're ever in doubt, it's better to seek emergency care immediately," says Dr. Juan Carlos Rozo, a cardiologist at Houston Methodist.

Dr. Rozo notes that signs of a heart attack aren't always obvious and can sometimes resemble heartburn symptoms. Some people who have a heart attack never experience the crushing chest pain we see on TV, and less common symptoms can include nausea, fatigue, back pain and more.

More than 60 million people in the U.S. have heartburn once a month or more, and studies have found more than 15 million have heartburn every day. Conversely, more than 800,000 Americans annually have a heart attack.

Knowing the difference between signs of heartburn and symptoms of a heart attack could save your life, or the life of someone you love.

Symptoms of heartburn and heart attack can be similar

Heartburn can be a sign of gastroesophageal reflux disease (GERD), the condition when acid reflux occurs frequently. It feels like a burning sensation in your chest between the stomach and the mouth caused by stomach acid flowing into the esophagus.

Severe cases of GERD can be signs of a condition leading to esophageal cancer, called Barrett's esophagus. For most people acid reflux can be treated with medications.

Symptoms of heartburn can include:

• A sour or acidic taste in the mouth
• Bloating
• Burping, belching or regurgitation
• Chest discomfort
• Difficulty swallowing
• Nausea
• Mild shortness of breath

A heart attack is a medical emergency that could lead to serious disability or death. It happens when the arteries that deliver blood to the heart become blocked. Sometimes, symptoms are sudden and intense. In other cases, they can appear days or weeks before the heart attack.

Symptoms of a heart attack can include:

• Chest discomfort
• Cold sweats
• Discomfort in the arms, back, neck, jaw or stomach
• Fatigue
• Irregular or fast heartbeat
• Lightheadedness
• Nausea
• Shortness of breath

Because symptoms of acid reflux and heart attack can overlap, Dr. Rozo recommends it's better to be safe than sorry.

"Treat urgent symptoms as a medical emergency," Dr Rozo says, "especially if chest discomfort is also associated with shortness of breath, cold sweats and nausea, or lightheadedness."

(Related: Home Remedies for Heartburn: 8 Ways to Get Rid of Acid Reflux)

Is there a way to tell the difference?

There are some ways to tell heart attack from heartburn, including how long symptoms last. Heartburn usually goes away after a few minutes or hours, when the food in your stomach has been digested. Heart attack does not.

"It's important that if there are any persistent symptoms that don't go away, do not wait," urges Dr. Rozo, "seek emergency care."

Other differences between heart attack and heartburn can help you tell the difference:

• Heartburn pain is limited to the esophagus. Heart attack can cause pain in the arms or jaw.
• Heartburn can cause a bad taste in the mouth. Heart attack does not.
• Heartburn feels like a burning sensation. Heart attack pain is most often described as squeezing, tightness or heaviness in the chest

If you're not sure whether you're having a heart attack, call 911.

(Related: Is Preventing Heart Attack or Stroke Possible with Heart Disease?)

Emergency care for heart attack symptoms

When patients arrive at the emergency room with symptoms of a heart attack, advanced protocols begin. Using testing like electrocardiogram (ECG) and a blood test, along with state-of-the-art cardiac imaging, such as cardiac CT and angiography, doctors determine if a heart attack is the cause.

If so, an interventional cardiologist will provide treatment via either coronary angioplasty or coronary artery bypass surgery. At Houston Methodist, experts provide comprehensive cardiology care, from the emergency room through long-term heart health management. (Related: 5 Commonly Ordered Heart Tests & What They Show)

"We also offer personalized care to help prevent these events from happening," says Dr. Rozo. "We have plans for lifestyle modification and medications, as well as minimally invasive procedures when needed. This helps ensure the best possible outcome."