What is the difference between indigestion and a heart attack

Every three minutes someone in the UK is struck by a heart attack, and 30% are fatal, so the faster help is given the better. Recognising the symptoms – or whether you are simply suffering from indigestion – and knowing what to do, is therefore very important.

What are the signs of a heart attack?

A heart attack occurs when one of the arteries to the heart gets completely blocked. This means the part of the heart supplied by that artery is starved of oxygen-rich blood, and the muscle is at risk of dying without medical help. The sooner the treatment, the more muscle you can save.

‘The most common sign of a heart attack is a severe, constricting, heavy pain in the chest,’ says consultant cardiologist Dr Andrew Archbold from BMI The London Independent Hospital. ‘It’s usually a diffuse pain starting in the centre or left of the chest, often radiating out into one or sometimes both arms, or into the jaw.’

However, Dr Archbold says it’s not a pain that you could point at with one finger and say ‘it hurts here’ like you could with a pulled muscle. Nor does it usually appear on its own – people having a heart attack often feel sick (and might even vomit), feel sweaty, clammy or breathless. Some say they also experienced a feeling of dread or doom.

Could it be anything else?

Because the pain experienced during a heart attack cannot be specifically located, and can often be mild, it can be confused with other sorts of chest pain such as indigestion or angina.

Is indigestion a sign of a heart attack?

Angina is an early warning sign that your arteries are narrowing. Its primary symptom is chest pain so the first time you experience it, you may think you’re having a heart attack.

‘Angina starts on exertion, but fades quickly with rest,’ says Dr Archbold. If your symptoms started when you were sitting still, don’t reduce when you rest or (if you’ve already been diagnosed) don’t stop after you’ve used your normal angina treatment, call an ambulance.

Indigestion also has very similar symptoms to a heart attack and may be the cause of your chest pain, particularly if you’ve had a very large or spicy meal in the hour before symptoms start. ‘Even doctors can’t always tell the difference without doing an EEG or a blood test, but it’s better to be safe than sorry,’ says Dr Archbold.

Does everyone get the same heart attack symptoms?

No – and this is when things get complicated. ‘About 10% of people get an atypical presentation where they feel chest pain but it’s not bad enough to immediately seek help,’ says consultant interventional cardiologist Dr Kamal Chitkara of BMI The Park Hospital in Nottingham. ‘This is particularly common in people with diabetes where the nerves can sometimes alter sensation so pain isn’t felt as acutely.’ 

Those who have had slowly progressing heart disease also don’t always get a severe pain. Dr Archbold says, ‘If you’ve had a progressive narrowing of the arteries, your body will actually create new channels, called collaterals, through which blood flows. During a heart attack – when that narrowed artery finally blocks – the collaterals still work, reducing your symptoms such as chest pain.’

Do women get the same symptoms?

Women, particularly pre-menopausal women, also don’t necessarily present with heart attacks in that ‘chest clutching’ way you see in movies. In fact, a study published in the journal Circulation found only 30% of women had traditional chest pain symptoms, and in many cases it was more of an ache than a pain. 

Instead, they had symptoms such as shortness of breath, weakness, nausea, stomach upset or back pain, which is extremely hard to diagnose as a heart attack. Extreme fatigue in the month before the attack was found to be the most common symptom – if you suddenly find you can’t do normal tasks, like make a bed without needing a rest, see a doctor urgently.

What to do if you suspect a heart attack

Always call 999 if you’re worried – the main reason people die from a heart attack is not seeking help soon enough. ‘If you suspect you’re having a heart attack, and can safely take aspirin, chew and swallow one tablet (ideally 300mg) as that can start to thin the blood. Then lie down with your head propped up and wait for help to arrive,’ says Dr Chitkara. 

Don’t go hunting for any aspirin if you don’t have some nearby; the exertion of climbing stairs to the bathroom cabinet could put extra strain on your heart. Stay calm and remember that help is on its way.

Once they receive professional medical care, most people who have a heart attack make a full recovery. Within a few months you should be back on your feet and back to normal life.

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May 25, 2022 | by Edward-Elmhurst Health

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Picture a 22-year-old guy out for the evening with friends. Settled in a favorite restaurant, he consumes a pile of hot wings with greasy fries, and chases it down with a couple of beers and countless cups of coffee. When he wakes up during the night with a burning sensation in his chest and a sour taste in his mouth, he blames last night’s food and drink choices, and pops some antacid tablets.

”For someone in their 20s with no risk factors of heart disease, it’s probably safe to assume that heartburn is causing these symptoms, especially if the antacid brings relief,” says Daryl Wilson, M.D., an emergency medicine physician at Edward Hospital.

Of course, chest pain isn’t always so benign. Some people are struck with the type of pain often associated with a heart attack — an overwhelming, crushing feeling that radiates into the arm or other parts of the body. In these cases, the afflicted person or someone who’s with them usually knows it’s time to call 911.

But some cases aren’t as black and white. Heartburn can closely mimic a heart attack. While a heart attack is often announced by pressure or pain in the chest, that’s not always true.

Says Dr. Wilson, “Atypical heart attack symptoms are especially common in women and diabetics.”

These symptoms can include jaw pain, nausea and vomiting, shortness of breath, extreme tiredness, sweating, dizziness and even heartburn.

Heartburn is caused by the contents of the stomach splashing up into the food pipe (esophagus). This acid reflux can cause a burning sensation anywhere from the belly button to the back of the mouth, but it’s more commonly felt in the upper abdomen.

Other symptoms can include nausea, belching and bloating. The patient can often find relief by taking a quick-acting acid-reducing medication.

Some of the other causes of chest pain are various cardiac issues, pneumonia, gastrointestinal problems and pulmonary embolism. The pain also can result from something as simple as a strained muscle.

Dr. Wilson says when a patient with chest pain comes to the ER they’ll be given an EKG (electrocardiogram), which detects deviations in heart activity, and a troponin test, which measures a protein in the blood that’s released during  a heart attack. The assessment will also include a look at the patient’s risk factors for heart disease, such as age over 40, obesity, high blood pressure, high cholesterol and family health history.

If there’s a heart attack diagnosis, additional cardiac testing and treatment typically follow. This might include medications and a procedure to eliminate blockages in the coronary arteries so that blood flow to the heart can be restored.

If a heart attack is ruled out and heartburn is suspected, the ER staff will give the patient a medication to coat the stomach, and suggest they follow up with their physician or gastroenterologist if the condition persists, or if they develop difficulty swallowing. Regular heartburn can increase the risk of damage to the esophagus and it might signal a more serious condition, such as gastroesophageal reflux disease (GERD) or cancer.

“If you are having unexplained chest pains, you should get to an emergency department so life-threatening causes can be ruled out,” says Dr. Wilson. “And don’t be embarrassed if the cause turns out to be something minor. It’s often impossible to tell the cause of chest pain without testing.”

To find out if you’re at risk for heart disease, take an online HeartAware assessment.

Learn more about heart and vascular services at Edward-Elmhurst Health.

Download PDF: (Infographic) Know the Signs of a Heart Attack

Learn more about emergency services at Edward-Elmhurst Health.

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