Is it heartburn or a heart attack? Don’t guess. 

EEHealth in its Healthy Driven Bog asks readers to picture a 22-year-old guy out for the evening with friends. Settled in a favorite restaurant, he consumes a pile of hot wings with greasy fries and chases it down with a couple of beers and countless cups of coffee. When he wakes up during the night with a burning sensation in his chest and a sour taste in his mouth, he blames last night’s food and drink choices, and pops some antacid tablets.

” For someone in their 20s with no risk factors of heart disease, it’s probably safe to assume that heartburn is causing these symptoms, especially if the antacid brings relief,” says Daryl Wilson, M.D., an emergency medicine physician at Edward Hospital.

Of course, chest pain isn’t always so benign. Some people are struck with the type of pain often associated with a heart attack — an overwhelming, crushing feeling that radiates into the arm or other parts of the body. In these cases, the afflicted person or someone who’s with them usually knows it’s time to call 911.

But some cases aren’t as black and white. Heartburn can closely mimic a heart attack. While a heart attack is often announced by pressure or pain in the chest, that’s not always true.

Says Dr. Wilson, “Atypical heart attack symptoms are especially common in women and diabetics.”

These symptoms can include jaw pain, nausea and vomiting, shortness of breath, extreme tiredness, sweating, dizziness, and even heartburn.

Heartburn is caused by the contents of the stomach splashing up into the food pipe (esophagus). This acid reflux can cause a burning sensation anywhere from the belly button to the back of the mouth, but it’s more commonly felt in the upper abdomen. 

Other symptoms can include nausea, belching, and bloating. The patient can often find relief by taking a quick-acting acid-reducing medication.

Some other causes of chest pain are various cardiac issues, pneumonia, gastrointestinal problems, and pulmonary embolism. The pain also can result from something as simple as a strained muscle.

Dr. Wilson says when a patient with chest pain comes to the ER they’ll be given an EKG (electrocardiogram), which detects deviations in heart activity, and a troponin test, which measures a protein in the blood that’s released during a heart attack. The assessment will also include a look at the patient’s risk factors for heart disease, such as age over 40, obesity, high blood pressure, high cholesterol, and family health history.

If there’s a heart attack diagnosis, additional cardiac testing and treatment typically follow. This might include medications and a procedure to eliminate blockages in the coronary arteries so that blood flow to the heart can be restored.

If a heart attack is ruled out and heartburn is suspected, the ER staff will give the patient a medication to coat the stomach and suggest they follow up with their physician or gastroenterologist if the condition persists, or if they develop difficulty swallowing. Regular heartburn can increase the risk of damage to the esophagus and it might signal a more serious condition, such as gastroesophageal reflux disease (GERD) or cancer.

“If you are having unexplained chest pains, you should get to an emergency department, so life-threatening causes can be ruled out,” says Dr. Wilson. “And don’t be embarrassed if the cause turns out to be something minor. It’s often impossible to tell the cause of chest pain without testing.”

To find out if you’re at risk for heart disease, take an online HeartAware assessment.

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