7 ways to tell if it’s heart pain or heartburn

About 1,000 Americans suffer sudden cardiac arrest every day, a catastrophic event that is almost always fatal.

The most common cause is a heart attack which sets off an electrical storm within the heart, halting the heart’s ability to pump blood to the heart, to the brain and to the rest of the body. Unless the heart is shocked back into rhythm promptly, death occurs within minutes.

Until recently, physicians believed these events occurred without warning. But a recent study shows that at least half of patients that experience cardiac arrest have symptoms in the 24 hours prior to the event.

The most common symptoms were chest pain and shortness of breath. More than 80% of people who experienced these symptoms ignored them, and unfortunately, that had a big impact on their outcomes. Those who called 911 had a 32% survival rate, compared to only 6% for those who did not seek immediate help.

So how do you know when to seek medical attention? We all get aches and pains, sometimes in the chest. And if we exert ourselves enough, we will eventually get short of breath.

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The signals the body sends us can be confusing. But when the signal is coming from your chest, the stakes are high.

But often people wonder if what they’re experiencing is just heartburn.

Related: Why heartburn meds set you up for heart attack

First and foremost, here’s a good rule to follow: If in doubt, check it out. It’s always better to be safe than sorry.

That said, there are some clues that can help discriminate between heart pain and simple heartburn:

  1. Heart pain tends to be brought on by exertion or stress and is relieved with rest. Heartburn has no relationship to physical activity. Instead, it tends to be related to the ingestion of food.
  2. Heart pain tends to occur in the context of risk factors for heart disease, including older age, family history of heart disease, history of high blood pressure, diabetes, high cholesterol, and/or history of tobacco use. Heartburn has no relationship to heart disease risk factors.
  3. Heart pain tends to be progressive over time — it will take less and less activity or stress to prompt the pain. Heartburn tends to remain more random.
  4. Heart pain is unlikely to occur spontaneously in the middle of the night. Heartburn classically wakes people up at 2 to 3 in the morning.
  5. Heart pain may be accompanied by shortness of breath, sweating, and a sense of doom. Heartburn tends to be an isolated symptom.
  6. Heart pain does not respond to antacids. Heartburn often gets better with over-the-counter medication like Maalox or TUMS.
  7. Heart pain is unlikely to be felt below the rib cage. Heartburn can be felt in the abdomen.

The thing is, none of these are absolute, which is why it’s important to listen to your body — and your intuition.

If you’re experiencing a new symptom in your chest, and especially if you have risk factors for heart disease, don’t ignore it. Contact your care provider and make an appointment to be checked out. And if you are experiencing chest pain or chest burning that is not going away — especially if it’s lasting more than 30 minutes — or if you have a sense that you need immediate care, head to the emergency room.

For more on your heart, health, and food that benefits both, visit Step One Foods.

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Dr. Elizabeth Klodas MD, FACC

By Dr. Elizabeth Klodas MD, FACC

"Diet is a major driver of high cholesterol, but instead of changing the food, we prescribe medications. This never seemed logical to me.” Dr. Klodas has dedicated her career to preventive cardiology. Trained at Mayo Clinic and Johns Hopkins, she is the founder and Chief Medical Officer for Step One Foods. Dr. Klodas is a nationally sought out speaker and has an active role at the American College of Cardiology. Her clinical interests include prevention of heart disease and non-invasive cardiac imaging and she has published dozens of scientific articles throughout her career. Dr. Klodas has been featured on CNN Health for her mission to change how heart disease is treated. An independent study performed at leading medical institutions affirmed the ability of Step One Foods to deliver measurable and meaningful cholesterol-reduction benefits in the real world. The results of the trial were presented at the 2018 American Heart Association’s Scientific Sessions. Dr. Klodas has also authored a book for patients, "Slay the Giant: The Power of Prevention in Defeating Heart Disease," and served as founding Editor-in-Chief of the patient education effort of the American College of Cardiology. In addition to her practice and her duties at Step One Foods, she also serves as medical editor for webMD.