by Amy Scholten, MPH
Richard had been battling digestive problems for most of his life. So when the 78-year-old developed persistent discomfort in the chest, he assumed it was just another severe case of heartburn . For several weeks, he tried antacids and other treatments, without relief.
One day on the golf course, Richard complained about the discomfort. His golf partner, a retired cardiologist, urged Richard to seek immediate medical attention. Richard learned that what he thought was heartburn was actually angina , and that despite his low cholesterol level, he had two severely blocked coronary arteries. It was recommended that he have emergency bypass surgery .
Its not unusual for people to mistake symptoms of heart disease (such as angina and even a heart attack ) for heartburn. Similarly, many people go to the emergency room each year out of fear that theyre having a heart attack, only to find out they have severe heartburn. The pain experienced during a heart attack and during a severe heartburn episode can be very difficult to distinguish. In fact, it often takes sophisticated medical testing to make the determination.
In addition to producing some similar symptoms, both heartburn and heart attacks are more likely to occur in people over the age of 40. Here are some possible differences between the two conditions. Please note: If you have any chest pain, or any warning signs of a heart attack, seek immediate medical attention by calling 911. Do not try to decide for yourself. Possible Signs of Heartburn A sharp, burning sensation below the breastbone or ribsBurning sensation may move up toward the throatPain usually doesnt radiate to the shoulders, arms, or neck, although it canPain often occurs after eating, particularly when lying downPain that increases when bending over, lying down, exercising, or lifting heavy objectsBitter or sour taste at the back of the throatSymptoms tend to respond quickly to antacids Possible Signs of Angina or Heart Attack A feeling of uncomfortable fullness, pressure, squeezing, tightness or pain in the center of the chest that lasts for more than a few minutes, or goes away and comes backPain or discomfort that spreads to one or both arms, the back, stomach, neck, or jawPain often responds quickly to nitroglycerinShortness of breath Other symptoms such as: Breaking out in a cold sweatNauseaLightheadednessFaintingPalpitations (feeling a rapid heart beat) Other Causes of Chest Pain Other problems that can cause chest pain include:
Other heart conditions, such as: Pericarditis inflammation of the sac surrounding the heart Aortic dissectiona rare, but dangerous condition in which the inner layers of the aorta (a blood vessel that originates from the heart and supplies blood to most of the body) separateCoronary spasmarteries supplying blood to the heart go into spasm, temporarily limiting blood flow to the heart muscle Panic attackperiods of intense fear accompanied by anxiety , chest tightness, rapid heartbeat, rapid breathing, profuse sweating, and shortness of breath Pleurisyinflammation of the lining of the chest and lungs, which causes chest pain that increases with coughing, inhalation, or deep breathingCostochondritisinflammation of the rib cage cartilage Pulmonary embolism a blood clot that gets lodged in the artery of the lung Other lung conditions, such as Collapsed lung Pulmonary hypertension Severe asthma Pneumonia Muscle-related chest painoften accompanies fibromyalgia and other chronic pain syndromesInjured ribs, pinched nervesbruised and broken ribs, as well as pinched nerves can cause localized chest pain 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 tube)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 Chest pain can be difficult to interpret. It could be something as benign as heartburn or as severe as a heart attack. You should seek emergency medical attention if you have any chest pain, and particularly if you have other signs and symptoms of a heart attack. A visit to the emergency room could save your life. RESOURCES: The American College of Gastroenterology http://www.acg.gi.org American Heart Association http://www.americanheart.org References: American Heart Association website. Available at: http://www.americanheart.org . National Heartburn Alliance website. Available at: http://www.heartburnalliance.org/ . National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://diabetes.niddk.nih.gov/index.htm . Last reviewed September 2006 by Lawrence Frisch, MD, MPH Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
