Harvard Heart Letter

Ask the doctor: What's the best way to tell heartburn from angina or a heart attack?

Ask the doctor

What's the best way to tell heartburn from angina or a heart attack?

Q. I'm worried that someday I will confuse my heartburn with my angina or a heart attack and end up in the emergency room for nothing. How do I tell the difference?

A. That's an excellent question, one that is often tough for doctors to answer without some further testing. Many people mistake heartburn for angina or a heart attack. Others ignore pain from angina or a heart attack because they think it is just heartburn.

One clue comes from what you were doing before the symptoms started. Heartburn tends to occur after meals, when you have more acid in your stomach, or when you are lying down, which allows stomach acid to trickle into the esophagus. Chest pain from angina is more likely to happen when you are exerting yourself or have been outside in the cold. (This isn't a 100% reliable rule, since angina can hit you after a meal, too.)

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