Heartburn vs. Heart Attack: How to Tell the Difference

Having chest pain can be scary, but it’s actually a common problem. In fact, there are about 6 million emergency room (ER) visits for chest pain in the U.S. each year. About 30% of the time, the cause is heartburn or other related symptoms. 

If you’ve ever had chest discomfort, you may have wondered how to tell if it’s due to heartburn or a more serious cause like a heart attack. Let’s take a closer look at how to tell the difference between the two — and how to know when your symptoms may be more serious. 

How do I know if I have heartburn, angina, or a heart attack?

Heartburn, angina, and a heart attack can all cause chest pain or discomfort — and this can feel very scary. These conditions are all very different. But it can be hard to tell them apart. 

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Some things that can give you a clue about what’s causing your pain is: 

• The presence (or absence) of any other symptoms

• How long the pain lasts

• What makes the pain better or worse

• What you were doing when the pain started 

Below, we’ll take a deeper dive into what symptoms you can expect with each condition and how to tell them apart. 

Heartburn

Heartburn is a symptom of gastroesophageal reflux disease (GERD). This is caused by acid from the stomach moving up into the esophagus. Another name for this is acid reflux. 

Heartburn is one of the most common medical conditions in the U.S. More than 60 million people — or over 15% of the population — experience heartburn at least once a month. 

Common triggers for heartburn include:

• Spicy foods 

• Acidic foods

• Alcohol

• Caffeine

• Certain medications (like antibiotics, aspirin, ibuprofen)

EXPERT PICKS: WHAT TO READ NEXT

• Silent heart attack: Find out the “silent” symptoms of heart attack to look for other than chest pain.

• Heart attack vs. angina: Here’s how to tell the difference between these two conditions.

• What’s causing your heartburn? Learn if your symptoms are due to gastroesophageal reflux disease (GERD) or something else.

Signs and symptoms of heartburn

If you have heartburn, you’ll likely feel a burning pain in the center of the chest behind your breastbone. Heartburn often occurs after eating. And it can be linked with other symptoms, like: 

• Nausea

• Abdominal pain

• Regurgitation of food

• Difficulty swallowing

How to treat heartburn

Mild, infrequent heartburn can be treated with over-the-counter (OTC) medications. If you have frequent heartburn or heartburn with other symptoms, it's a good idea to discuss this with a healthcare professional. This is because GERD can cause damage to the esophagus over time, so you may need other treatments to prevent complications. 

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Angina

Angina describes chest pain caused by a lack of oxygen to the heart. This can occur for many reasons. But one common cause is a blockage or narrowing of the coronary arteries (vessels that bring blood to the heart). The blockage limits the amount of oxygen-rich blood getting to the heart muscle.

Symptoms of angina

When the heart doesn’t get enough oxygen, you can have symptoms of chest pain. You may feel any of the following in the center or left side of the chest:

• Discomfort

• Burning

• Pressure

• Heaviness

• Tightness

Sometimes the pain may move to different areas of the body, like your: 

• Neck

• Back

• Jaw

• Arms

Angina is worse when your heart works harder: It's most noticeable with any type of physical activity, and it gets better with rest. Most episodes of pain last about 2 to 5 minutes.

Treatment of angina

If you have symptoms of angina, it's important to discuss them with a healthcare professional. Angina is often treated with medications. But you may need a procedure or surgery to fix a blocked artery in some cases. If a healthcare professional thinks you may have angina, you may be referred to a cardiologist (heart specialist) to help with the diagnosis and treatment. 

Heart attack

A heart attack happens when part of a blockage or plaque in the coronary artery breaks off and completely or mostly prevents blood flow to part of the heart. This lack of blood flow can cause long-term damage to the heart if it's not treated right away. 

Signs and symptoms of a heart attack

A heart attack can also cause chest pain associated with discomfort, pressure, or heaviness throughout the chest. It may move into the: 

• Arms

• Jaw

• Neck

• Back

Chest pain from a heart attack doesn’t get better with rest from physical activity. And it tends to last longer (20 minutes or more). Chest pain from a heart attack is often associated with other symptoms, including:

• Shortness of breath

• Lightheadedness

• Fatigue

• Sweating

How to treat a heart attack

If you think you're having a heart attack, it's important to get treatment right away at the nearest ER. This is because immediate treatment can be lifesaving and prevent long-term damage to the heart. 

Do heart attacks and heartburn feel similar?

Although heartburn and heart attacks have different causes, they can feel similar. Both can cause chest pain and discomfort in the center of the chest, so it can be hard to distinguish between the two.

Heartburn signs

If you have a burning pain behind your breastbone that started after a spicy meal and otherwise you feel well, it's likely you have heartburn. Often, heartburn can be easily treated with OTC antacids. If you try this and your symptoms go away, that is a good indicator they were caused by heartburn. 

Many people also get heartburn more than once. So, if you had heartburn in the past and experience the same symptoms again, it's likely another case of heartburn.

Heart attack signs

Angina and heart attacks can also cause a burning pain or discomfort in the chest, so it's important to notice other symptoms. For example, if you also feel short of breath or light-headed, it might be something more serious (more on that below). 

If you're unsure about your symptoms, or if you have chest pain that feels different from what you had in the past, be sure to talk to a healthcare professional. 

They can help you determine if your symptoms are from heartburn or a more serious cause. 

Heart attacks in women

It's important to know that heart attacks in women can have different symptoms. Women can have chest pressure and heaviness. But they may also have no chest pain at all. Instead, women may have symptoms that could be mistaken for another illness, like:

• Nausea

• Fatigue

• Lightheadedness 

Is heartburn a symptom of a heart attack?

Heartburn is often a symptom of GERD, but it can also be a symptom of a heart attack. In fact, heart attacks can cause other symptoms that usually happen with GERD, such as nausea, burping, and vomiting. In this case, the symptoms usually don’t occur by themselves and will come with other symptoms that point to a more serious cause. 

Signs that heartburn is a warning of something more serious

Heartburn is often not serious and will go away on its own or with OTC medications. If you have heartburn that occurs with other symptoms, it could be a sign of a more serious problem. These symptoms may include:

• Shortness of breath

• Dizziness or lightheadedness

• Feeling faint 

• Fatigue or weakness

• Sweating

• Feeling clammy

• Increased heart rate 

If you have heartburn or chest pain with any of these symptoms, it's important to get immediate medical attention. This is because these symptoms could mean there’s a more serious cause that requires urgent treatment.

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Written by:

Sarah Pozniak, MD

Sarah Pozniak, MD, has 9 years of experience since graduating medical school (6 since completing residency). She is a board-certified general internal medicine physician and has practiced as a primary care physician in both Utah and Washington, D.C. Currently, she cares for patients with chronic illnesses such as diabetes and high blood pressure using telemedicine as part of a virtual care program.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Farzon A. Nahvi, MD

Dr. Nahvi is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works clinically at Concord Hospital in Concord, New Hampshire, and is a clinical assistant professor of emergency medicine at the Geisel School of Medicine at Dartmouth. Prior to this, he worked as an ER physician and clinical assistant professor of emergency medicine at the Mount Sinai Health System, NYU Langone Health, NYC Health + Hospitals/Bellevue, and the Manhattan VA. He is a graduate of Cornell University and NYU School of Medicine.

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