Heartburn is the symptom of acid reflux and GERD; however, not everyone with acid reflux has heartburn and not everyone with heartburn has acid reflux. The symptom of heartburn can also be caused by other unusual things such as intestinal motility problems. Cardiac problems can also mimic heartburn and you should not confuse the two. Unexplained chest pain should be evaluated by an exercise stress test or EKG prior to an evaluation for gastrointestinal problems.
Many people have different acid reflux-related heartburn triggers, but most people have similar heartburn symptoms.
A burning feeling in the chest just behind the breastbone that occurs after eating and lasts a few minutes to several hours.
Chest pain, especially after bending over, lying down, or eating.
Burning in the throat -- or hot, sour, acidic or salty-tasting fluid at the back of the throat.
Feeling of food "sticking" in the middle of the chest or throat.
Heartburn may cause chronic cough, sore throat, or chronic hoarseness.
Reporting these symptoms is usually all that is needed for your doctor to make the diagnosis of heartburn. However, your doctor may perform special tests to determine the severity of your problem or to monitor your treatment. Special tests may also be needed if you have unusual symptoms such as weight loss or suffer from the complications of GERD.
Chest pain is one of the most common reasons a person goes to the emergency room. While many of these patients are suffering from a heart attack, some actually may be experiencing severe heartburn.
Often, the pain caused by a heart attack and during a severe heartburn episode is so difficult to distinguish that sophisticated medical testing is needed to determine whether or not you are having a heart attack. To complicate matters even more, the two problems have many of the same symptoms and occur in similar types of people (For example, older age and overweight people.)
Signs more typical of heartburn include:
A sharp, burning sensation just below the breastbone or ribs.
Pain generally does not radiate to the shoulders, neck, or arms, but it can.
Pain usually comes after meals, when lying on the back, when exercising or when experiencing anxiety.
Symptoms usually respond quickly to antacids.
Rarely accompanied by a cold sweat.
Signs more typical of angina (severe pain in chest area) or heart attack include:
A feeling of fullness, tightness, or dull pressure or pain generally in the center of the chest.
The feeling of a belt being tightened around your chest
Sudden chest pain or pressure that worsens
Pain may spread to the shoulders, neck, jaw or arms
Pain often responds quickly to nitroglycerin
Shortness of breath
Often accompanied by a cold sweat
If you have any pain that lasts for more than a few minutes or any warning signs of a heart attack, seek immediate medical attention. If there's any confusion about whether your symptoms are heartburn or a heart attack, also seek immediate medical attention.
International Foundation for Functional Gastrointestinal Disorders, Inc.
American Association of Family Physicians.
American Gastroenterological Association.
DeVault, K. and Castell, D. American Journal of Gastroenterology, 2005; vol 100: pp 190-200.
Pettit, M. Pharmacy World and Science, December 2005; vol 27: pp 432-435.
Talley, N. and Vakil, N. American Journal of Gastroenterology, October 2005; vol 100: pp 2324-2337.