How would you differentiate between a heart attack and heart burn ?

Dr Harold Gunethilake

This is something that every householder must be aware of. I had the experience recently when my wife at 2 am complained of chest pain and also burning sensation in the chest after returning from a dinner party at a friend’s home. She said, for the first time she had two glasses of white wine. Having had stents in the coronary vessels, anyone would suspect a recurrent heart attack due to blockage of one or more coronary vessels. I was about to call the ambulance, but then when I questioned further she said, she had bloating of the stomach, but she was not breathless. Remember, any person having a heart attack will be breathless, and not in heartburn. It is unlikely that heart attack will present with bloating or belching of the stomach. This difference is very important to remember.

Remember, heart burn is only a symptom due to stomach acid refluxing into the gullet. This comes about in persons who are obese and the valve or sphincter at the oesophageal/ stomach junction (cardia) just below the diaphragm is incompetent. Sometimes the valve may be competent but the excess gas in the stomach due to gas producing foods such as vegies and potatoes can reflux acid to the gullet as a release phenomenon.

In heart attack the onset is sudden and invariably you would bend and press against the chest for some relief. You may get the feeling that you are been pressed in a vice and the constrictive discomfort is typical. You may sweat, become breathless as mentioned, may be difficult to talk or have the presence of mind to describe it.
On the other hand, a person having heart burn will be aware of previous bouts and would know it is only burning sensation in the gullet with abdominal symptoms like bloating, belching, and nausea and would not panic as much as in a heart attack.

Coming back to my wife’s situation, I had a mini pocket cardiac monitor which I carry wherever when I leave home. It has been useful on flights to help other passengers. When checked with the monitor the reading said that the wave pattern was normal. In the medical parlour we call it sinus rhythm. Her blood pressure was checked with my portable wrist BP apparatus (everybody must carry one) and was in the normal range.

I asked her to drink some cold milk from the refrigerator- she burped after drinking a cupful and said that she is relieved. Keep some sliced cucumber in the fridge- they are most soothing for heartburn.

Do not give aspirin in a situation like this. It worsens the heat burn.

So remember, this can happen to one of your loved ones at home. Do not panic and act sensibly and wisely.

Good advice by Dr harold