Chest pain can be alarming — and for good reason. But is it heartburn, or something more serious like a heart attack?
While the symptoms can feel similar, a few key differences can help you tell them apart.
1. Does it feel like burning?
If yes, it’s likely indigestion: Because it’s caused by acid reflux, it has a distinct burning sensation.
A heart attack — which is caused by a lack of oxygen to the cardiac muscle — has more complicated symptoms. But helpfully, burning isn’t one of them.
“Typically, cardiac chest pain is a pressure sensation. Patients have described it as an elephant sitting on their chest,” says Chad Conner, MD, a cardiologist at Hartford HealthCare Heart & Vascular Institute. “Although some people — particularly women and individuals with diabetes — have less common symptoms like nausea, sweating, shortness of breath, palpitations or dizziness.”
2. Is the discomfort only in your chest?
If yes, the mystery continues: It could either be indigestion or a heart attack.
If not, and odd sensations are showing up in other parts of your body, it’s more likely a heart issue — because those symptoms are known to travel.
“Often, pressure you feel from a heart attack radiates beyond the chest,” says Dr. Conner. That can include your shoulders, neck, back, arms, and even jaw.
> Related: 10 “Silent” Signs of a Heart Attack That You Should Know
3. Did you eat recently?
To be specific: Did you recently eat a large meal, or eat a regular-sized meal very quickly, or eat and then lay down?
Put a checkmark in the indigestion column. Your odds of acid reflux just went up.
“Indigestion is often associated with eating or around mealtime or laying down at night, when acid from the stomach can more easily travel up the esophagus,” says Dr. Conner.
4. Does acid reflux medicine make a difference?
If you still suspect simple heartburn, and you already have antacids or proton pump inhibitors on hand, try taking one. If your discomfort improves, it’s probably indigestion.
Just don’t pursue this experiment for more than a few minutes.
“If your pain persists 15 minutes or more, get evaluated at the local emergency department,” says Dr. Conner. “The faster you act in a cardiac situation, the less damage to your heart.”
> Related: How to Choose the Right Acid Reflux Medication
5. Are you at particular risk for heart disease?
This is hopefully a conversation you and your doctor have had already. Just in case, here’s a reminder.
Risks for heart disease include:
- High blood pressure
- High cholesterol
- Smoking
- Obesity
- Family history
- Prior history of coronary artery disease
If any of these apply to you, take your symptoms seriously.
“The more risk factors you have, the more likely the pain you’re feeling could be associated with your heart, as opposed to indigestion,” says Dr. Conner.
Your shortcut: Indigestion or heart attack?
Here’s the big takeaway.
What you’re feeling is likely indigestion if:
- It has a burning quality.
- You only feel it in your chest.
- Heartburn medication makes an immediate difference.
- You don’t have any known risks of heart disease.
Unless all these things are true, you could be having a heart attack — and should go to the hospital.
“Never be embarrassed to go to the emergency department,” says Dr. Conner. “Chest pain can have several causes, from a heart attack to indigestion to lung or muscle or even rib problems. It can be difficult to differentiate. My best advice is to be cautious.”
Often, with bloodwork and a simple EKG, a health expert can tell for sure what you’re experiencing. You’ll either get the care you need, or eliminate the stress of not knowing.
Either way, you’ll feel better.
