You're taking a walk around the block after dinner when you feel pain in your chest. Is it just heartburn, a result of the spaghetti and meatballs you enjoyed earlier in the evening? Or could you be having a heart attack? Find out how to distinguish between the two, and what you should do if you experience chest pain.

 

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.

Pain May Be Difficult to Distinguish

It’s 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 they’re 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. Do not try to decide for yourself.

Possible Signs of Heartburn

• A sharp, burning sensation below the breastbone or ribs
• Burning sensation may move up toward the throat
• Pain usually doesn’t radiate to the shoulders, arms, or neck, although it can
• Pain often occurs after eating, particularly when lying down
• Pain that increases when bending over, lying down, exercising, or lifting heavy objects
• Bitter or sour taste at the back of the throat
• Symptoms 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 back
• Pain or discomfort that spreads to one or both arms, the back, stomach, neck, or jaw
• Pain often responds quickly to nitroglycerin
• Shortness of breath
• Other symptoms such as:
  • Breaking out in a cold sweat
  • Nausea
  • Lightheadedness
  • Fainting
  • Palpitations (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 dissection – a 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) separate
  • Coronary spasm – arteries supplying blood to the heart go into spasm, temporarily limiting blood flow to the heart muscle
• Panic attack – periods of intense fear accompanied by anxiety, chest tightness, rapid heartbeat, rapid breathing, profuse sweating, and shortness of breath
• Pleurisy – inflammation of the lining of the chest and lungs, which causes chest pain that increases with coughing, inhalation, or deep breathing
• Costochondritis – inflammation 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 pain – often accompanies fibromyalgia and other chronic pain syndromes
• Injured ribs, pinched nerves – bruised 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:

American College of Gastroenterology
http://www.acg.gi.org

American Heart Association
http://www.americanheart.org

Sources:

American Heart Association

National Heartburn Alliance

National Institute of Diabetes and Digestive and Kidney Diseases

ThirdAge WWW