Heartburn, indigestion or heart attack?


Although very different, heartburn, indigestion and heart disease can all cause chest pain, which might be cause for concern.

While frequent heartburn and indigestion may occasionally be secondary to more serious conditions, any pain arising from heart disease is always serious. It's important to recognise when your symptoms are serious so that you can get the medical attention you need.

Differences in types of chest pain

Heartburn gives rise to a burning pain in the stomach that goes up along the food pipe into the throat. The pain tends to get worse if you lie down on your back or bend down.

Indigestion is closely related to heartburn and may cause a burning chest pain. You may also have accompanying abdominal discomfort.

Chest pain during a heart attack can be very severe and is usually described as a crushing or squeezing pain, focused on the left side of the chest or at the centre. The pain may also go up to the jaw or down the left arm. The pain may not always be severe – it can sometimes be mild and can even be mistaken for indigestion. It's not the severity of the pain that indicates you're having a heart attack, it's the combination of symptoms you're experiencing.

Associated symptoms

Look at the other symptoms you are having along with chest pain. These will help you decide which sort of condition is causing your pain.

If you have heartburn, you may get a metallic taste in your mouth. You may also experience bloating, belching or passing wind as these are commonly associated with indigestion.

A heart attack is a more likely cause if you get any of these symptoms alongside chest pain:

• Shortness of breath

• Dizziness or lightheadedness

• Feeling sweaty

• Fainting or loss of consciousness

• Palpitations or an irregular pulse

• An overwhelming feeling of anxiety

You may get nausea and vomiting with both of these conditions.

Factors in causing your pain

Check what happened before you experienced the pain.

Heartburn often occurs after a meal, especially if larger than usual, after consuming alcohol, or after eating spicy, high-calorie (such as desserts) or fatty food.

Indigestion usually arises after large meals and after eating spicy or rich food.

Heart attacks are most commonly caused by coronary heart disease. This is where a fatty substance called cholesterol builds up in the arteries that supply blood to your heart. This causes the arteries narrow, blocking blood from getting to your heart. If blood supply to the heart is interrupted, which is especially likely if these fatty deposits burst, a heart attack is triggered.

Other factors that increase the burden on the heart, like misusing stimulant drugs or carbon monoxide poisoning, can also cause a heart attack.

These factors also increase your risk of having a heart attack:

• A family history of heart disease, particularly if you have close relatives who suffered from heart disease before the age of 60

• Having diabetes, especially if uncontrolled, high blood pressure, and high cholesterol levels

• Being male

• Being obese

• Smoking – just a cigarette a day can increase your risk of a heart attack considerably

Next steps

• If you believe that you are experiencing a heart attack, seek medical attention immediately. Call 999 for an ambulance to take you to A&E. Crushing chest pain, fainting, palpitations and shortness of breath are serious symptoms and should never be ignored

• You may attempt to treat heartburn or indigestion yourself or with the help of your pharmacist. See your Doctor, however, if you get frequent episodes