Matters of the heart can be quite muddling, as any hopeless romantic, Shakespearean scholar, or cardiologist will attest. Since February is American Heart Month, let’s take a beat to focus on one of the most confounding feelings around this vital organ: the symptomatic overlap between heart attack and indigestion.
“Patients often mistake a heart attack for indigestion,” says Roper St. Francis Healthcare interventional cardiologist Dr. Sam Powell. “Rarely does a week go by that a patient doesn’t tell me they’ve spent days, even weeks, treating their chest discomfort as indigestion without improvement.” So what, exactly, do these common occurrences have in common?
The same, but different
The term heart attack refers to the sudden and life-threatening loss of blood—and thus, oxygen—to the heart, usually due to an arterial blockage. Indigestion, on the other hand, is a loose name for gastroesophageal reflux disease (GERD), which occurs when stomach acid finds its way into the upper chest and esophagus, often in response to particular foods. In either case, patients may experience chest discomfort.
“There’s a great deal of overlap between the symptoms of a heart attack and indigestion,” says Dr. Powell. “As cardiologists, we’ve actually shifted the narrative around heart attacks from ‘chest pain’ to ‘chest discomfort,’ because heart attacks are associated with more than just pain but also pressure and squeezing in the chest.” Of course, indigestion can also manifest as an uncomfortable or squeezing sensation in the chest.
Which is which?
The presentation of these symptoms can differ slightly, however. Chest discomfort that is left-sided or radiates to the neck, arm, or shoulder is more indicative of a heart attack, particularly when accompanied by sudden sweatiness, nausea, or shortness of breath. Smokers and tobacco users; people over 65; and patients with underlying medical conditions such as type 2 diabetes, kidney disease, autoimmune disorders, high blood pressure, high cholesterol, and obesity also face a greater risk of heart attack.
Alternatively, chest discomfort that changes (either improves or worsens) based on body position or with deep breaths points towards a non-cardiac cause, such as indigestion, especially if it’s on the heels of eating a large meal or triggering food.
Follow your heart
“Unfortunately, there’s no home test to tell if a person’s discomfort is simply due to indigestion,” stresses the cardiologist. With so much ambiguity between the sensations of a heart attack and GERD, it’s best to seek medical help for any new chest discomfort. “If there’s ever a concern, you’re never wrong to go to the emergency room.”
There, doctors will evaluate your medical history, ask about activities leading up to the discomfort, and gauge your current level of pain or discomfort. A patient then undergoes blood tests and an electrocardiogram (EKG), a fast, non-invasive test using adhesive electrode pads to record the heart’s electrical patterns and determine what’s really going on.
“If your symptoms turn out to be indigestion, not much has been lost. But there’s a whole lot more to lose by assuming it’s not a heart attack and staying home,” says Dr. Powell, stressing that heart disease remains the number one cause of death in American men and women. While a poet may regard love as a worthy risk, one’s heart health isn’t worth gambling on. If you or a loved one ever experiences sudden, unexplained chest discomfort, seek immediate medical attention from one of Roper St. Francis Healthcare’s six full-service emergency rooms.