Heartburn or Heart Attack? Many Can't Tell the Difference

Washington, D.C. - Many adults (64 percent) know severe chest pain is typically involved as a symptom of acid reflux disease, but even so, a majority of adults say they would most likely call 911 or go to the emergency room immediately if they were experiencing severe chest pain. According to a new survey of more than 2,000 U.S. adults commissioned by AstraZeneca and conducted by Harris Interactive, nearly one in five U.S. adults (18 percent) have, or know someone who has, called an ambulance or gone to a hospital thinking they were having a heart attack, but it turned out to be heartburn or acid reflux disease. Acid reflux disease, in which stomach acid flows back into the esophagus, often causes burning pain or pressure in the chest.

Chest pain can be even more alarming for those who have previously been diagnosed with either angina (chest pain) or a heart attack. According to the AstraZeneca survey, these adults are four times more likely than those without either condition (20 percent vs. 5 percent) to have sought emergency assistance for symptoms that turned out to be heartburn or acid reflux disease.

"Many types of chest discomfort can be caused by acid reflux disease. Yet this connection is often overlooked because the symptoms of cardiac angina can be so similar to noncardiac chest pain from GERD," said John P. Liuzzo, M.D., Ph.D., Division of Interventional Cardiology, Columbia University Medical Center, New York. "Physicians could be more aware of acid reflux disease as a possible factor in the diagnosis and treatment of patients with chest pain."

Studies have shown that half the time, noncardiac chest pain (i.e., pain not caused by heart disease) in people with coronary artery disease (CAD) may be caused by acid reflux disease. A recent clinical study presented in November at the 78th American Heart Association Scientific Sessions in Dallas, Texas, reported that CAD patients with previous chest pain who added a proton pump inhibitor (PPI) to their regular heart medication regimen had less noncardiac chest pain, visited their doctor complaining of noncardiac chest pain less often, and were admitted to the hospital for noncardiac chest pain less often than those taking a placebo (dummy pill).

"Sometimes, the chest pain may be accompanied by other symptoms, such as heartburn or acid regurgitation," said John Bonhomme, M.D., MPH, senior faculty advisor, Grace Crum Rollins School of Public Health, Emory University. "But it is important for anyone experiencing these symptoms not to assume they are being caused by acid reflux disease. Only a physician can diagnose the underlying cause of chest pain, so it's important that people seek prompt medical treatment."

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