Heartburn Or Chest Pain: When To Start Worrying

By MaryAnn DePietro, CRT. May 7th 2016

It can be difficult to distinguish heartburn from chest pain caused by cardiac problems or other conditions. Both cardiac related chest pain and heartburn can come on suddenly and cause discomfort in the chest; however, there are more differences in the two conditions than similarities. Heartburn is actually not related to the heart, while other types of chest pain can be a sign of cardiac problems, such as a heart attack. Understanding the difference between heartburn and chest pain is essential to getting proper treatment.

What Causes Heartburn?

Heartburn occurs when stomach acid flows up into the esophagus. The esophageal sphincter acts like a valve and normally helps prevent stomach acid from traveling up to the esophagus. In some instances, acid gets through the valve and a burning sensation is felt in the chest and possibly the throat. Occasional heartburn may be caused by eating too fast or eating a large, greasy meal.

Heartburn also commonly occurs during pregnancy. The hormone progesterone produced in pregnancy may cause the esophageal sphincter muscle to relax, which allows acid to move up. Later in pregnancy a growing baby puts extra pressure on the stomach, which may also push stomach acid up.

When heartburn occurs frequently, it may be due to a condition called gastroesophageal reflux disease (GERD). According to the University of Chicago Medicine, GERD is often caused by a weak lower esophageal sphincter muscle. Many times the muscle may become weak due to a hiatal hernia.

Causes Of Chest Pain

Chest pain can be caused by several different medical problems, which range from minor problems to life threatening conditions. One serious cause of chest pain is a heart attack, which occurs when the blood supply to the heart is reduced. In addition to a heart attack, chest pain can also be caused by other cardiac problems, such as inflammation of the lining of the heart, or lining of the chest wall.

Certain respiratory conditions can also cause chest pain including pneumonia, a blood clot in the lung and a severe asthma attack. Additional causes of chest pain include muscle strains, shingles and panic attacks.

Differences In The Type Of Pain

Although both cardiac related chest pain and heartburn can cause pain there are usually several differences in the type of pain. For instance, heartburn is often a burning in the middle of the chest behind the breastbone, which usually does not spread. If heartburn does spread, it is usually to the throat.

Chest pain, which is cardiac in nature, usually can be described as tightness in the chest or a crushing pain. Chest pain may also spread from the chest to the jaw, back and shoulders.

What type of activity preceded the start of the pain may also shed some light on whether the pain is heart related or due to heartburn. According to Columbia University, heartburn often starts after a large meal, especially if greasy food was eaten. Chest pain caused by heart problems may start at anytime, but is frequently associated with exertion or increased stress.

Consider Other Symptoms

Another important way to distinguish between heartburn and chest pain is by considering other symptoms that are present. Heartburn may be accompanied by a sour or bitter taste. Pain often becomes more intense when lying down or bending over.

Chest pain may also be accompanied by additional symptoms depending on the cause. For example, additional symptoms, which may develop with chest pain caused by a heart attack, include light-headedness, nausea, a fast heart rate and a cold sweat. Shortness of breath also often occurs with chest pain.


Treatments for heartburn and other types of chest pain are very different. Treatment for heartburn usually consists of lifestyle changes, such as losing weight if needed, quitting smoking and changing certain eating habits. Limiting foods including fried, greasy or high fat foods may help reduce heartburn. Antacids may also be recommended, which neutralize stomach acid. For more information, see 10 Foods To Avoid If You Suffer From Heartburn.

In cases of GERD, additional medications may be recommended, including proton pump inhibitors, which reduce stomach acid. In instances of severe GERD when lifestyle changes and medication don’t work, surgery may be recommended to strengthen the esophageal sphincter.

Treatment for chest pain will depend on whether the pain is due to a cardiac problem or not. Cardiac related chest pain will require medical testing to determine if the arteries are clogged. In some instances, surgical procedures to unblock the arteries will be required. Medication may also be prescribed to treat chest pain, such as nitroglycerin, to relax the arteries. Blood thinners and anti-anxiety medications may also be used to treat chest pain.

Keep in mind, chest pain can be a symptom of a life threatening condition and should never be ignored. Even if you think it is heartburn, it should always be checked out by a doctor. Although there are several things, which help distinguish chest pain from heartburn, it is always better to err on the side of caution and see your doctor.


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