Heart Attack vs Heartburn: How to Tell the Difference

What Is a Heart Attack?

A heart attack — medically known as a myocardial infarction — occurs when the blood supply to part of the heart muscle is suddenly blocked, causing that portion of the heart to begin dying. The most common cause is coronary artery disease, in which fatty plaques build up inside the arteries that supply the heart.

When a plaque ruptures, a blood clot forms rapidly at the site, blocking the artery entirely. Without prompt treatment to restore blood flow, heart muscle is permanently damaged. Time is critical: the faster blood flow is restored, the better the outcome.

Heart attack symptoms

• Chest pain, tightness, or pressure — often described as a heavy weight, squeezing, or crushing sensation
• Pain lasting more than a few minutes, or coming and going repeatedly
• Pain or discomfort spreading to the jaw, neck, arms (especially the left arm), back, or stomach
• Shortness of breath, with or without chest discomfort
• Cold sweats, nausea, or vomiting
• Sudden fatigue, light-headedness, or dizziness

What Is Angina?

Angina is chest pain caused by reduced blood flow to the heart — similar in mechanism to a heart attack, but typically temporary and without permanent muscle damage. It develops when coronary artery disease narrows the heart’s arteries enough to limit blood supply during periods of increased demand.

Stable angina is predictable — it occurs during exertion or stress and eases with rest or glyceryl trinitrate (GTN) spray. Unstable angina can occur at rest, is less predictable, and signals that a heart attack may be imminent. Unstable angina is a medical emergency.

Because angina can produce a burning or tight sensation in the chest, it is sometimes confused with heartburn. Unlike heartburn, however, it does not typically respond to antacids and is more closely linked to physical activity.

What Is Heartburn?

Heartburn is the burning sensation caused by acid reflux — when stomach acid escapes upward into the oesophagus (food pipe). Despite its name, heartburn has nothing to do with the heart. It is caused by a digestive process, and it is entirely possible to have severe heartburn with a perfectly healthy heart.

The stomach produces powerful hydrochloric acid to digest food and kill bacteria. It has a protective mucous lining; the oesophagus does not. When the valve between the two — the lower oesophageal sphincter — relaxes at the wrong time or fails to close properly, acid enters the unprotected oesophageal lining and causes pain.

Heartburn symptoms

• Burning sensation in the centre of the chest, often rising towards the throat
• Sour or acidic taste at the back of the mouth or throat
• Symptoms that worsen after meals, when lying down, or when bending forward
• Relief from antacids (Gaviscon, Rennies)
• Accompanying belching, bloating, or nausea

Heartburn that occurs more than twice a week, or that is severe, persistent, or associated with other symptoms, is classified as gastro-oesophageal reflux disease (GORD) and requires medical treatment. Read our full acid reflux explained guide for a detailed overview.

Key Differences: Heart Attack vs Heartburn

Even experienced clinicians sometimes struggle to distinguish these conditions on symptoms alone — particularly because both can cause chest discomfort. However, several features help differentiate them.

When to Call 999

Call 999 immediately — do not wait — if you experience any of the following:

• Chest pain, tightness, or pressure lasting more than a few minutes
• Chest discomfort that comes and goes over several minutes
• Pain or discomfort spreading to your jaw, neck, left arm, or back
• Shortness of breath alongside chest discomfort
• Cold sweats, pallor, or clammy skin
• Sudden nausea or vomiting with chest symptoms
• Feeling faint or losing consciousness
• Any chest pain that you cannot explain and that worries you

When to See a Doctor for Heartburn

Most people with occasional heartburn can manage their symptoms with lifestyle changes and over-the-counter antacids. However, you should seek medical advice if:

• Heartburn occurs more than twice a week
• Symptoms do not improve after two weeks of over-the-counter treatment
• You experience difficulty swallowing or the sensation of food sticking
• You have unexplained weight loss alongside heartburn
• You are over 55 and have new or worsening symptoms
• You are pregnant and experiencing severe or persistent symptoms

These symptoms may indicate GORD or, rarely, a more serious underlying condition such as Barrett’s oesophagus or oesophageal cancer, both of which require investigation.

Heartburn Treatment Options

Lifestyle modifications

Many people significantly reduce heartburn frequency with simple lifestyle changes: eating smaller meals, avoiding trigger foods (fatty meals, alcohol, coffee, chocolate), not eating within three hours of bedtime, and raising the head of the bed.

Antacids and alginates

Over-the-counter products such as Gaviscon (an alginate) and Rennies (an antacid) are suitable for mild, infrequent heartburn. Gaviscon forms a protective raft over stomach contents, reducing reflux; antacids neutralise existing acid.

Proton pump inhibitors (PPIs)

For frequent or persistent heartburn, proton pump inhibitors (PPIs) such as omeprazole or lansoprazole are the most effective treatment. They significantly reduce the amount of acid the stomach produces, allowing the oesophagus to heal and preventing further damage. Learn more in our complete guide to proton pump inhibitors.

GORD: When Heartburn Becomes a Disease

Gastro-oesophageal reflux disease (GORD) is the clinical diagnosis given to acid reflux that is frequent, severe, or causing complications. In the UK, approximately one in five adults experiences GORD symptoms regularly.

Untreated GORD can cause oesophageal inflammation (oesophagitis), ulcers, narrowing of the oesophagus (stricture), and — in a small number of people — Barrett’s oesophagus, which carries a slightly increased risk of oesophageal cancer. Regular, appropriate treatment reduces these risks significantly. For detailed information on managing GORD with PPIs, see our guide on PPIs, peptic ulcers, and GORD.