Is It Heartburn or a Heart Attack?

rerun image You have pain that starts in your chest and moves up your throat. You want to assume it’s heartburn but the worry about a heart attack is in the back of your mind. It is not unusual for people to mistake symptoms of heart disease for heartburn. Many people have also gone to the emergency room out of fear of a heart attack, only to find out it was severe heartburn. In truth, the symptoms can be very similar. In fact, it often takes medical testing to determine the true cause.

Pain May Be Difficult to Distinguish

Here are some facts that may help.

Possible Signs of Heartburn

  • A sharp, burning sensation below the breastbone or ribs
  • Burning sensation may move up toward the throat
  • Pain often occurs after eating, particularly when lying down
  • Pain increases when bending over, lying down, exercising, or lifting heavy objects
  • Bitter or sour taste at the back of the throat
  • Symptoms respond quickly to antacids

Note: Call for emergency medical services right away if you have any chest pain. Even if you think it may be heartburn.

Possible Signs of Angina or Heart Attack

  • A feeling of uncomfortable fullness, pressure, squeezing, tightness, or pain in the center of the chest (may last for more than a few minutes or goes away and comes back)
  • Physical exertion or emotional stress triggered problems
  • Pain or discomfort spreads to one or both arms, the back, stomach, neck, or jaw
  • Shortness of breath

Other symptoms may include:

  • Breaking out in a cold sweat
  • Nausea
  • Lightheadedness
  • Fainting
  • Rapid heartbeat

Other Causes of Chest Pain

Heartburn and heart attacks are not the only conditions that can cause chest pain. Other problems that can cause chest pain include:

  • Other heart conditions, such as:
    • Coronary spasm—arteries to the heart spasm, temporarily limiting blood flow to the heart muscle
    • Pericarditis—inflammation of the sac surrounding the heart
    • Aortic dissection—rare, but dangerous condition in which the inner layers of the aorta separate
  • Damage or irritation to tissue of the chest wall such as:
    • Costochondritis—inflammation of the rib cage cartilage
    • Muscle-related chest pain—can occur after heavy coughing or an injury to the chest or with chronic pain syndromes like fibromyalgia
    • Injured ribs, pinched nerves
  • Lung conditions, such as:
    • Pleurisy—inflammation of the lining of the chest and lungs, which causes chest pain that increases with coughing, inhalation, or deep breathing
    • Pulmonary embolism —a blood clot lodged in the artery of the lung
    • Atelectasis—collapsed lung
    • Severe asthma
    • Pneumonia—lung infection
  • Panic attack—periods of intense fear accompanied by anxiety, chest tightness, rapid heartbeat, rapid breathing, profuse sweating, and shortness of breath
  • Shingles —infection of a nerve root, caused by reactivation of the chickenpox virus
  • Gallbladder or pancreas problems—gallstones or inflammation of the gallbladder or pancreas can cause abdominal pain, which can radiate to the chest
  • Disorders of the esophagus—swallowing disorders such as esophageal spasms and achalasia (failure of esophageal muscle to relax)
  • Cancer —cancer involving the chest or that has spread from another part of the body

Seeking Medical Attention for Chest Pain

It can be hard to determine the cause of chest pain. Call for emergency medical services right away if you have any chest pain. Especially if you have other signs and symptoms of a heart attack.

Do not have someone drive you to the hospital. Emergency medical crews can provide treatment on the way to the hospital. The sooner treatment is given the better the outcomes for heart attacks.


The American College of Gastroenterology
American Heart Association


Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada


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Heart attack. American Heart Association website. Available at:
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ST-elevation myocardial infarction (STEMI). EBSCO DynaMed website. Available at:
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Last reviewed May 2018 by Michael Woods, MD
Last Updated: 7/21/2018

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