Heart attack and heartburn are two different conditions that can have a similar symptom: chest pain. And while some movie depictions of heart attacks make them seem like big, chest-clutching displays, that’s not always the case.

This article explores some ways to tell the difference between heartburn and heart attack. However, if you’re ever unsure about what you may be experiencing, it’s always better to be safe than sorry.

If your chest pain is making you nervous, head to the nearest emergency room.

To understand how these two conditions can cause chest pain, consider the causes behind the two.

Heart attack

A heart attack (also called a myocardial infarction) is when a major artery or arteries in your heart don’t get enough blood flow. As a result, areas of your heart don’t get enough blood and oxygen. Doctors call this state ischemia.

To understand ischemia, think about going from standing still to running a full-out sprint.

At the end of a few seconds, your lungs are likely burning and your chest feels tight (unless you’re a star athlete). These are some examples of very temporary ischemia that gets better when you slow your pace or your heart rate catches up.

However, when a person has a heart attack, their heart can’t work to produce more blood flow. The results can be chest pain, but other symptoms occur too.

Different arteries in the heart supply blood to different areas of the heart. Sometimes, a person’s symptoms can vary because of where they’re experiencing their heart attack.

Other times, the symptoms are different because people’s bodies respond differently to lack of blood flow and oxygen.

Heartburn

Heartburn occurs when acid that’s usually in your stomach rises up into your esophagus (the tube between your mouth and stomach) and sometimes into your mouth.

The acid in your stomach is meant to dissolve foods and nutrients. Your stomach lining is strong enough so it’s not affected by the acid.

However, the lining of the esophagus doesn’t have the same kind of tissues as the stomach. When the acid comes up into the esophagus, it can create a burning sensation. This can cause chest pain and discomfort.

While heartburn and heart attack both have chest pain as a symptom, the areas in and around the chest that are affected by pain, and the pain sensations themselves, are slightly different.

Heartburn typically includes a burning sensation that starts in the upper part of the stomach and radiates to the chest.

A heart attack typically includes an uncomfortable sensation in the center or left side of the chest that’s sometimes described as pressure, squeezing, or a “fullness.”

Both heart attack and heartburn have additional symptoms, which may include:

HeartburnHeart attack
pain that usually takes place after eatingpain that comes on suddenly
sour tasteshortness of breath
burning sensation in your throatpain or discomfort in your neck, jaw, or back
discomfort in the shoulders (one shoulder or both)
feeling weak or faint

Again, if you’re feeling a very uncomfortable sensation in your chest and can’t be sure whether it’s heartburn or a heart attack, it’s always better to err on the side of caution and see a doctor ASAP.

Women and heart attacks

Do women experience heart attack symptoms differently than men?

According to the University of Utah, while the symptoms of a heart attack are technically the same in men and women, it’s possible that women may experience pain differently than men.

This differentiating pain threshold level may cause women to either underreport symptoms or simply ignore them.

This pain threshold difference is not scientifically proven, however, and there are other studies that find women are more sensitive to pain.

Another reason women may have a different reaction to symptoms of a heart attack is that this health issue is sometimes portrayed as a “man’s issue” in popular culture.

But according to the Centers for Disease Control and Prevention (CDC), every year in the United States, heart disease (which includes heart attacks) kills just as many women as it does men.

So it bears repeating: If you’re feeling tightness or pain in your chest, and you can’t think of a direct cause, call 911 or local emergency services, or get to a doctor as soon as you can.

The questions below are designed to help you if you’re ever in a situation where you’re trying to decide whether you or someone else is experiencing a heart attack or just heartburn.

1. What makes your symptoms better?

With heartburn, sitting up and taking antacids usually helps the pain. Lying flat and bending forward makes it worse.

With a heart attack, antacids and sitting up likely won’t improve your symptoms. Activity will usually make them worse.

2. When did you last eat?

With heartburn, you’re most likely to have symptoms within a couple of hours after eating. If you haven’t eaten anything in a while, it’s less likely your symptoms are reflux-related.

With a heart attack, your symptoms aren’t eating-related.

3. Does the pain radiate?

With heartburn, your pain may go up to your throat.

With a heart attack, the pain may go up to the jaw, back, or down one or both arms.

4. Are you short of breath or sweating?

With heartburn, your symptoms should not usually be this severe.

With a heart attack, these symptoms can indicate ischemia and a need to seek emergency medical attention.

Heart attack and heartburn aren’t the only causes of chest pain, but they’re two of the most likely ones. Other potential symptoms include:

  • Anxiety attack. Severe bouts of anxiety can cause panicked feelings that may make you feel as if your heart is racing. Other symptoms include shortness of breath and intense fear.
  • Esophageal muscle spasm. Some people have an esophagus that tightens or spasms. If this occurs, a person can have pain and discomfort, such as chest pain.
  • Gallbladder pain. The gallbladder is responsible for releasing bile that the body uses to digest fats. It can become blocked or diseased (such as with gallstones), causing symptoms like pain in the shoulders, arms, and neck as well as nausea and vomiting.
  • Pleurisy. This condition is an inflammation of the tissues in the chest wall, often due to intense coughing or inflammation from an infection.

If you’re having chest pain that you think could be a heart attack, don’t drive yourself to the emergency room. Always call 911 or local emergency services so you can get medical attention as quickly as possible.

The more time the heart goes without proper blood flow, the more damage the heart muscle may undergo. This is why it’s not a good idea to wait or hesitate if you think you may be experiencing a heart attack.

While a key symptom of both heart attack and heartburn is chest pain, there are other symptoms that can help differentiate between the two issues.

However, it’s always better to be cautious than to simply default to “I’m fine, it’s probably nothing.”

If you’re ever in a situation where you’re experiencing chest pain — especially if it comes on suddenly and is accompanied by pain in your shoulders or nausea — call 911 as soon as you can.

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