Chest pain is a frequent medical concern that often triggers anxiety because it can arise from both harmless and life-threatening sources. This discomfort can be caused by a blockage in the heart’s blood supply, known as a myocardial infarction or heart attack. It can also result from less severe issues, such as trapped gas or acid reflux. Self-diagnosis is dangerous, and any new or severe chest pain should always be evaluated by medical professionals.
Understanding Heart Attack Symptoms
A myocardial infarction occurs when a coronary artery is blocked by a blood clot, which starves the heart muscle of oxygen. The classic symptom is heavy pressure, tightness, squeezing, or crushing heaviness in the center of the chest. This pain typically lasts for more than a few minutes or may go away and return.
The discomfort may radiate outward from the chest to the jaw, neck, back, or down one or both arms. Accompanying symptoms often include shortness of breath, a cold sweat, lightheadedness, and dizziness. Nausea and indigestion-like feelings can also be signs of a heart attack.
Symptoms can vary widely, and not everyone experiences the dramatic “Hollywood” heart attack. Women are more likely to present with non-classic symptoms like unexplained fatigue, upper back pain, or nausea and vomiting without severe chest pain. Older adults and those with diabetes may also experience a “silent” heart attack with only mild or ambiguous symptoms.
Recognizing Gastrointestinal Causes of Chest Pain
Non-cardiac chest pain frequently originates from the digestive system, as the esophagus runs close to the heart and shares similar nerve pathways. Gastroesophageal reflux disease (GERD), or acid reflux, is a primary cause, creating heartburn when stomach acid backs up into the esophagus. This burning can be severe and easily mistaken for cardiac pain.
Trapped gas leads to pressure or a sharp, stabbing discomfort in the chest or upper abdomen. This occurs when gas produced during digestion presses against the diaphragm, which separates the chest and abdominal cavities. Sudden contractions of the esophageal muscles, known as esophageal spasms, can also generate intense, squeezing pain that mimics a heart attack.
Gastrointestinal pain is often triggered by specific events, such as eating a large meal, consuming spicy or fatty foods, or lying down too soon after eating. Stress and anxiety can also disrupt digestive function, contributing to symptoms like bloating or fullness. The pain can range from a dull ache to a sharp sensation.
Key Differences to Identify the Source of Pain
Nature of Pain
Cardiac pain is typically heavy pressure, squeezing, or fullness, often likened to an elephant sitting on the chest. Gastrointestinal pain, conversely, is characterized as a sharp, stabbing, burning, or cramp-like sensation. Acid reflux pain presents as a burning feeling traveling up from the stomach area.
Location and Radiation
Heart attack pain commonly involves the central chest and spreads to the left arm, jaw, neck, or back. Pain localized to the lower chest or upper abdomen, or which is tender to the touch, suggests a gastrointestinal or musculoskeletal cause. Gas pain often remains central but can be felt as a generalized pressure across the chest.
Triggers and Timing
Cardiac pain is often brought on by physical exertion or emotional stress, increasing the heart’s need for oxygen. Gastrointestinal pain is triggered by eating, drinking alcohol, or changes in body position, such as bending over or lying flat. Heart attack symptoms generally last longer than a few minutes and do not resolve quickly.
Relief Mechanisms
Heart attack pain is usually not relieved by position changes, burping, or antacids. Gastrointestinal pain is often alleviated by passing gas, belching, or taking antacid medication. Antacids can temporarily relieve non-cardiac chest pain, but this should not be used to definitively rule out a cardiac event.
Accompanying Symptoms
Heart attack symptoms are often accompanied by distress, such as cold sweating, lightheadedness, and shortness of breath. Gastrointestinal issues are more likely to include bloating, a sour taste in the mouth due to regurgitation, or excessive burping. A feeling of impending doom is also associated with a myocardial infarction.
Immediate Action: When to Call Emergency Services
If you experience sudden, severe chest discomfort, especially if accompanied by shortness of breath, cold sweats, or pain radiating to your jaw or arm, call 911 immediately. The principle to follow is “Act First, Ask Later,” as assuming it is a minor issue can have fatal consequences. Never attempt to drive yourself to the hospital, as this delays definitive care and puts others at risk.
While waiting for emergency medical services to arrive, sit down, rest, and try to remain calm. If you are not allergic and have been advised by the emergency operator, you may be instructed to chew a regular-strength 325 mg aspirin, which helps prevent further blood clotting. If there is any doubt about the cause of your chest pain, treat it as a cardiac emergency until proven otherwise.