Heartburn or Heart Attack: Symptoms Doctors Say You Can’t Ignore

The experts at National Jewish Health share when to seek emergency care

DENVER - Chest pain could be a sign of a heart attack or heartburn. Doctors at National Jewish Health say the difference is not always obvious, so addressing the symptoms quickly could save your life.

“It is fairly common for heartburn to mimic the symptoms of a heart attack,” said Pranav Periyalwar, MD, a gastroenterologist at National Jewish Health. “It is very important to seek medical care quickly and not dismiss it and say, ‘It is just a little indigestion. I may feel better.’”

Distinguishing heartburn from a heart attack: Common symptoms

Common symptoms that may indicate either heartburn or a heart issue include:

Once cardiac issues are ruled out and emergency care is not needed, Dr. Periyalwar usually treats patients for acid reflux, where the stomach acid backs up into the esophagus causing inflammation that usually results in heartburn.

Dietary triggers for acid reflux and heartburn

Depending on the patient, Dr. Periyalwar said the timing of acid reflux varies drastically. Some get it on an empty stomach, while others get it overnight. However, it almost always revolves around diet.

Certain foods cause reflux more than others by increasing the production of stomach acid, slowing down digestion and irritating the esophagus. During this time, a patient’s muscle band known as the lower esophageal sphincter malfunctions when it should be preventing the acid from traveling from the stomach.

The biggest triggers of acid reflux include:

• Alcohol
• Carbonated drinks
• Coffee
• Greasy food
• Processed food
• Spicy food

“If you eat foods that are whole fruits, vegetables and lean meats without extra sauces added to them, then typically that would reduce reflux symptoms,” Dr. Periyalwar said.

Dr. Periyalwar also explained that the law of gravity then comes into play. He recommends patients avoid eating right before bed and sleep with their head elevated to keep stomach acid down and alleviate pressure. Reducing stress, increasing physical activity and taking medication may also help manage reflux.

According to Dr. Periyalwar, these interventions can result in “a significant improvement in symptoms and oftentimes a complete resolution of reflux symptoms.”

The link between acid reflux and respiratory complications

Dr. Periyalwar stressed the importance of treating reflux early because stomach acid can enter the lungs in some cases and turn into respiratory infections and scarring on the organs, which many times can be irreversible.

He also noted many patients treated for respiratory symptoms actually have undiagnosed reflux since irritation from stomach acid in the throat and airways can mimic issues like chronic cough or asthma.

“That is particularly gratifying if it is something as simple as reflux, helping to prevent them from needing steroids and long term asthma inhalers,” Dr. Periyalwar said.

According to National Jewish Health, acid reflux impacts more than 20 percent of adults in the U.S.

National Jewish Health is the leading respiratory hospital in the nation delivering excellence in multispecialty care and world class research. Founded in 1899 as a nonprofit hospital, National Jewish Health today is the only facility in the world dedicated exclusively to groundbreaking medical research and treatment of children and adults with respiratory, cardiac, immune and related disorders. Patients and families come to National Jewish Health from around the world to receive cutting-edge, comprehensive, coordinated care. To learn more, visit njhealth.org or the media resources page.