Angina and Acid Reflux Part 1: Is it heartburn or a heart problem?
Is it time for an antacid or an ambulance? This Part 1 guide will help you distinguish between heart-related chest pain and reflux symptoms.
Chest pain can be scary, and the stress of not knowing what is causing it certainly doesn’t help. What does help? Knowing the basic differences between these often-confused conditions: how they feel, their symptoms, and typical triggers.
Understanding Chest Pain
Severe heartburn is no picnic, but neither is angina. Not to be overly dramatic, but being able to differentiate between the two may be a matter of life or death. Simply put, both conditions cause chest pain. However, while these conditions do sometimes co-exist, it’s more likely that the pain you’re experiencing is due to either angina or reflux.
Angina, sometimes called angina pectoris, affects about 11 million Americans. It occurs when one or more arteries block the flow of oxygen-rich blood to part of the heart. Reflux or its more severe variation, gastroesophageal reflux disease (GERD), on the other hand, is not caused by a lack of blood flow. Instead, it’s due to the flow of digestive “juices” from the stomach coming back up the esophagus, where they cause pain.
Angina, sometimes called angina pectoris, affects about 11 million Americans. It occurs when one or more arteries block the flow of oxygen-rich blood to part of the heart. Reflux or its more severe variation, gastroesophageal reflux disease (GERD), on the other hand, is not caused by a lack of blood flow. Instead, it’s due to the flow of digestive “juices” from the stomach coming back up the esophagus, where they cause pain.
Angina: Chest Pain From the Heart
There are several types of angina, and it doesn’t always require emergency treatment. Most of the time, angina comes and goes. But, since heart disease is a leading cause of death in the U.S., it pays to be informed and proactive.
- Stable angina is the most common type. Common triggers of stable angina include physical exertion, emotional distress or stress, and exposure to cold weather. Physical exertion during wintertime, such as shoveling/snowblowing during a snowstorm, is a frequent cause for some. In fact, in those who have it, stable angina is quite predictable. Stable angina subsides with rest and medicine.
- Microvascular angina can cause pain or other symptoms that last longer than is typical for stable angina, and are triggered more by regular daily tasks and mental strain than physical effort. Its symptoms may feel a little different, too—more gastrointestinal-related—than other types of angina (nausea, stomach pain).
- Unstable angina begins suddenly, unpredictably, and rapidly gets worse. This type of angina can lead to a heart attack and is considered a medical emergency.
- Variant angina, also known as Prinzmetal angina or vasospastic angina, is rare. It occurs in younger, healthier people than the other two types, and happens during sleep or rest. It is managed with medication.
Important Note: To be on the safe side, if your chest pain does not subside with rest or prescribed medicine, call 911/emergency services. It’s always better to be safe than sorry.
What Angina Feels Like
Experiencing an angina “attack” can be alarming, but if you can discern the symptoms, you’ll be better able to describe it to your doctor or emergency medical personnel. People who have angina may experience one or more of the following typical symptoms:
- Pressure or squeezing sensation in the chest
- Feeling of fullness in the torso
- Shortness of breath
- Dizziness
- Arm pain
Angina in Women
It’s important to note that women often don’t experience heart problems like angina in the same way that men do. While chest pain may be the most common symptom, there are other symptoms that don’t “point” to heart troubles—such as anxiety, excessive tiredness, upset stomach, and vomiting. Because of this, treatment is often delayed, and that puts women at high risk.
Acid Reflux (GERD): Chest Pain From the Esophagus
While the heart itself is not involved, the location of acid reflux pain earned the condition the nickname “heartburn.” Luckily, occasional reflux is not a life-or-death matter but a quality-of-life issue. And recurring reflux not only causes pain, but can have some lasting health implications, too.
What Reflux-Related Chest Pain Feels Like
Acid reflux and its more persistent form, gastroesophageal reflux disease (GERD), most commonly present as pain right in the middle of your chest or around your heart. So, while “heartburn” isn’t exactly accurate, the pain it causes is legitimate.
A burning sensation in the chest (usually near the base of the sternum) is by far the most common description of reflux pain. But not everyone feels reflux the same way. Here are some other ways it’s described:
- Dull ache in the chest
- Irritated or hoarse throat
- Nausea
- Pain when swallowing
Associated Symptoms of Reflux
Aside from the pain associated with acid reflux or GERD, there are other symptoms that can help you differentiate reflux from angina:
- Regurgitation is when the stomach contents move back up into your throat or mouth. This is not a common symptom of angina, but it is a pretty classic symptom of GERD or reflux.
- A sour or acidic taste in the mouth is a less common symptom of GERD. When that taste is accompanied by an excess of saliva, it’s often called “water brash.” Water brash can feel like heartburn in the throat.
Common Triggers of Reflux Chest Pain
There are several common triggers for reflux, many of which can be addressed through lifestyle changes. For example, modifying what and how you eat can make a big difference in whether you experience reflux burn after a meal. Similarly, the way you position yourself after eating can also help prevent (or promote) reflux.
- Learn your trigger foods and beverages
- Eat more slowly and chew thoroughly
- Practice portion control; avoid eating large amounts of food at one sitting
- Do not recline immediately after eating, and avoid prolonged bending over
FAQs
How can I tell the difference between acid reflux and angina?
While both conditions can cause chest discomfort, angina often feels like pressure, squeezing, heaviness, or fullness in the chest and may be accompanied by shortness of breath, dizziness, or pain radiating to the arm, neck, jaw, or back. Acid reflux is more commonly described as a burning sensation in the chest and may be associated with regurgitation, a sour taste in the mouth, or throat irritation. However, symptoms can overlap, making it difficult to distinguish between the two without medical evaluation.
When should chest pain be considered a medical emergency?
Seek immediate medical attention or call 911 if chest pain is sudden, severe, worsening, occurs at rest, does not improve with prescribed medication, or is accompanied by symptoms such as shortness of breath, dizziness, fainting, sweating, or pain spreading to the arms, jaw, neck, or back. It is always safer to have chest pain evaluated promptly than to assume it is heartburn.
Can women experience angina differently from men?
Yes. Although chest pain is common in both sexes, women may also experience symptoms such as unusual fatigue, nausea, indigestion-like discomfort, anxiety, vomiting, or shortness of breath. Because these symptoms may not immediately suggest a heart problem, women sometimes experience delays in diagnosis and treatment.
Can acid reflux cause chest pain that feels like a heart attack?
Yes. Acid reflux can cause significant chest discomfort that may feel similar to heart-related pain. This similarity is one reason why new, unexplained, or severe chest pain should never be self-diagnosed. A healthcare professional can determine whether symptoms are related to the heart, digestive system, or another cause.
What lifestyle changes may help reduce reflux-related chest pain?
Several lifestyle habits may help reduce reflux symptoms, including identifying and avoiding trigger foods, eating smaller meals, chewing food thoroughly, avoiding lying down immediately after eating, and maintaining an upright posture after meals. If reflux symptoms occur frequently or interfere with daily life, discuss them with a healthcare provider, as recurring symptoms may indicate gastroesophageal reflux disease (GERD).
References
1National Heart, Lung, and Blood Institute. (n.d.). Angina. https://www.nhlbi.nih.gov/health/angina
2National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Definition & Facts for Acid Reflux (GER & GERD) in Adults. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/definition-facts
3American Heart Association. (n.d.). Angina Pectoris (Stable Angina). Retrieved from https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/angina-pectoris-stable-angina
4American Heart Association. (n.d.). Microvascular angina. https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/microvascular-angina
5American Heart Association. (n.d.). Unstable Angina. https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/unstable-angina
6National Center for Advancing Translational Sciences. (n.d.). Prinzmetal Angina. *Rare Diseases Information*. Retrieved from https://rarediseases.info.nih.gov/diseases/7465/prinzmetal-angina
7American Heart Association. (n.d.). Angina in women can be different than men. https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/angina-in-women-can-be-different-than-men
8National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Acid Reflux (GER & GERD) in Adults: Symptoms & Causes. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes
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