Is it a heart attack or heartburn?
By Mr Nur Choudhury MPharm (Ind. Prescriber)
The general guidance is that anyone worried about chest pain should seek immediate medical treatment. They should urgently call for an ambulance particularly if the pain is unexpected, abrupt, or serious.
As the pain from heart attack and heartburn can present in similar ways, if anyone is confused with the symptoms they are experiencing, they should always seek immediate medical care.
What is a heart attack?
A cardiac attack is an event triggered by coronary artery disease. The blood vessels are responsible for the supply of oxygen around the body, as well as to the heart muscles providing it with energy and keeping it alive. The narrowing of the blood vesicles supplying the heart muscles is a condition known as coronary artery disease, and can eventually lead to a heart attack. Heart attack happens when one of the blood supplying arteries in heart is blocked. Angina is chest pain that occurs from the narrowing of those arteries.
A heart attack is also known as a cardiac arrest. Heart specialists often use the term “acute coronary syndrome” or ACS to discuss heart failures and severe heart disorders such as Angina pectoris.
Symptoms of a heart attack
Some of the common symptoms of heart attack are as following:
- Tightness and heaviness of chest.
- Chest pain that feels like a heavy weight pressing against the chest
- Pain might come and go, but stays longer than a couple of minutes
- Some other less common symptoms of heart attack include;
- breaking into cold sweat
- shortening of breath.
- Feeling nauseated.
- feeling fatigued and dizzy.
It should be noted that not all heart failures show the same effects. Symptoms may be moderate to extreme and certain heart attacks may have no symptoms. The pain in the chest can be central or central left, but it is not always the case. It can travel to other regions too and can severely impact jaw, neck, both limbs and spine.
Individuals who may experience fewer symptoms when they have a cardiac arrest include the elderly and others with diabetes. Nevertheless, some individuals can also experience certain signs such as shortness of breath.
What is angina?
Angina is a form of chest pain similar to that triggered by a heart attack. Combined with the decreased flow of blood to the heart induced by a blockage of the coronary artery, it is also triggered by narrowing of the blood vessels supplying the heart.
Individuals with angina are at higher risk for a heart attack. Anyone who has angina should be alerted to this risk and must be under medical care. Temporary pain is the most frequent cause of angina that goes away after rest or treatment, this is also called stable angina. Unstable angina is much more unpredictable and can happen at any time, without any trigger factors such as strenuous exercise or stress.
What is heartburn?
It is important to note that heartburn is a symptom of a disease, and not an illness. It is the feeling induced by acid reflux, typically, intense discomfort in chest.
Indigestion is when the contents of food in the stomach are flushed back into the food pipe.
Heartburn is a sensation that is sometimes experienced in the upper or lower chest and is triggered by the gastric acid that goes back into the food tube.
Heartburn and heart attack are not linked in anyway. Usually, the uncertainty stems from where the discomfort is. The stomach produces mucus, to shield itself from acid used for the digestion of proteins. Acid reflux can damage the lining of the food pipe, but does not cause any serious harm in most people. The cause of why individuals face pain by acid reflux is not completely known.
Heartburn causes a feeling of burning inside the food pipe. This form of burning pain usually happens right over the heart. Also, the acid may travel further upwards, probably as far as the back of the mouth and throat.
Other symptoms of heartburn include:
Differences between symptoms of heartburn and heart attack
The symptoms of heartburn and heart failure can appear to be quite similar. Doctors also consider it complicated, and rely on testing, to create a decision based on symptoms alone.
For starters, a doctor at Harvard told his tale about heart disease. Whenever he exercised he had a burning sensation in his upper belly, but heartburn treatment did not improve his symptoms. Not until he became short of breath and therefore unable to carry on, did he seek medical assistance. Tests showed cardiac failure directly linked to having a heart attack.
The primary difference between the two symptoms is that:
- Heartburn can get worse after a meal and lying down but a heart attack can occur at any time regardless of food.
- Drugs that lower acid levels in the stomach can help relieve heartburn, but do not help with symptoms of a heart attack.
- Breathlessness is not caused by heartburn.
- Heartburn causes belching bloating while this does not happen with heart attack.
When to call a doctor
Anyone with the following symptoms should call 999 immediately:
- Pain or irritation in the chest, such as tightness, rubbing, pain or fullness that lasts more than a few minutes or goes away and returns
- Sickness or distress in other parts of the body, such as one or both arms, back, jaw, neck or stomach
- Shortness of breath, before or with chest discomfort
- Cold sweat
- Nausea and dizziness
- Feeling lethargic
All of these symptoms can affect men as well as women but:
Women are more vulnerable to jaw pain, diarrhoea, vomiting and perhaps other symptoms
Chest pain appears to be a common sign in males
It is crucial to go to an emergency department immediately anytime there is some suspicion of a heart attack.
When to see a doctor for heartburn
People who have acid reflux must make a doctor’s appointment, if:
- Symptoms continues for long periods of time
- Meat ‘gets stuck’ in the throat
- Dietary problems
- Loss of weight
- Blood in the stools
- Difficulty respiring or swallowing
Prolonged exposure to acid in the stomach may harm the intestines. These can also be the signs of a more severe illness, such as gastroesophageal reflux disorder (GORD), cancer, or peptic ulcer.
Treatment for heartburn
- The diagnosis of heartburn is through a combination of:
- Evaluation of the symptoms: The doctor will inquire where, how frequently, and for how long the symptoms appear, the degree of seriousness, and how the condition differs and reacts to the diets, the attitude of the individual, etc.
- Treatment response: This examines how symptoms react to stomach acid suppressant medications.
- Food pipe imaging: Endoscopy is done to see the damaged part of the stomach.
- pH testing of the food pipe: This can measure the level of acidity.
Treatment will depend on the cause.
This may include:
The usage of medicinal products (antacids) to neutralize stomach acid and prevent reflux, popular brands include Gaviscon and Peptac.
Use of other products known as proton pump inhibitors (PPI’s) including Lansoprazole and Omeprazole will reduce the amount of stomach acid produced by the body and is often more effective in long-term management of indigestion, acid reflux and even for the treatment for gastroesophageal reflux disorder (GORD).
(Antacids such as Gaviscon are accessible over the counter for purchasing, however PPI’s will need to be prescribed by your GP, or by visiting an online doctor).
- Improvements in diet, consuming lighter and more regular meals for starters
- Reducing consumption of reflux-inducing foods, such as spicy and greasy meals
- Maintaining a healthy weight including regular exercise
- Refraining from smoking and reducing alcohol consumption
In summary, whilst the symptoms of heartburn can often be confused with the symptoms of a heart attack, they are in fact different in nature, severity and diagnosis.
Treatment of coronary heart disease will require a detailed diagnosis considering any current risk factors and developing a long-term treatment plan, whilst the cause of heartburn and indigestion can be easier to diagnose and treat, with more simpler lifestyle changes and medication to control the build-up of acid.