Most people experience minor twinges of chest pain now and then. And when it happens, we can't help but wonder if it is something serious. Is it heartburn or a heart attack?
These two maladies have similar symptoms, but very different outcomes. Delaying treatment of heart attack may cost you your life. On the other hand, no one wants to take an ambulance trip if the pain could be cleared up with an antacid.
"The reason that heartburn has 'heart' in its name is because it's extremely difficult to differentiate a heart attack from heartburn," says Harvey Kramer, M.D., director of Cardiovascular Disease Prevention at Danbury (Conn.) Hospital.
This first thing to consider is your heart attack risk, according to Chauncey Crandall, M.D. "People with coronary heart disease, heart attack survivors, or those who have undergone coronary artery bypass surgery or had a stent implanted should not hesitate to get help," says Dr. Crandall, chief of the Cardiac Transplant Program at the Palm Beach Cardiovascular Clinic.
If you are over 50, have a family history of heart disease, have high blood pressure, diabetes, are obese, or inactive, you are also at greater risk and should err on the side of caution.
There are also key differences in the symptoms of heartburn and a heart attack that can help you decide whether to call 911, say Dr. Crandall and Dr. Kramer.
Where is the pain located? If the pain is located in the center of the chest, the shoulder, jaw, neck, or back, it may be a heart attack. On the other hand, if the pain is a burning sensation in the throat and is accompanied by a bitter taste in the back of the throat, that's most likely heartburn.
When does the pain strike? If the pain occurs shortly after you’ve eaten, it may very well be heartburn, especially if you lie down after eating. Heart attack chest pain more commonly occurs during exertion. Cardiac pain generally does not occur at rest, while heartburn does.
Telltale symptoms: Heart attack symptoms may include shortness of breath, sweating, fainting, nausea, and lightheadedness. These do not often happen with heartburn. "If you get associated symptoms like sweating and shortness of breath with the discomfort, that's more likely to be caused by cardiac chest pain, not heartburn," notes Dr. Kramer. "Women often present with atypical symptoms of heart attack, so they are more likely to experience these symptoms."
Other factors: If you are on antibiotics or other medications that could irritate the stomach, that’s an indication for heartburn. For people who take nitroglycerin for angina relief, things can be tricky. Sometimes nitroglycerin relieves the pain of heartburn.
Most important: Remember, there are no hard-and-fast rules. If you’re experiencing chest pain that you suspect may be heart-related, chew a 325-milligram aspirin if you have one handy, but calling 911 is your first priority. Also, don’t drive to the hospital yourself. An ambulance is a better option because emergency measures can be taken on the way to the hospital that could save your life.
Also, hot weather is a major risk factor for heart attacks. In fact, extremely high temperatures kill more people in the U.S. than hurricanes, earthquakes, lightning, and floods combined. Heart attack rates go up during heat waves and also during cold spells, making it important for those at risk to stay in a controlled environment during extreme temperatures.
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