Indigestion, or heartburn, is a very uncomfortable feeling that is caused by gastro-esophageal reflux. It’s a common problem that many people struggle with daily, and some people only suffer from it after a large heavy meal or a meal that is spicy. Although most people are very familiar with what heartburn feels like, the pain can be severe and alarming, and very difficult to distinguish from chest pain, which could indicate coronary artery disease or an impending myocardial infarction (heart attack.) Especially in individuals who know that they are at risk for heart disease (family history, obesity, smoking, high cholesterol, hypertension, clinical depression) heartburn can send many people to the emergency room.
It’s easy to understand why: the pain and nausea associated with heartburn are hallmark symptoms of a heart attack, and people have been warned by the medical community to never ignore these symptoms when they are found in conjunction together, according to News4Jax. Although some very common signs of heart attack include difficulty breathing, a feeling of impending doom and anxiety, pain in the jaw, teeth or arm, nausea and vomiting, chest pain that is unrelieved by rest, profuse sweating, and feeling weak, not all people who are having a heart attack experience all of these symptoms. In fact, in women, diabetics and the elderly, they may not experience any of these symptoms — what is commonly called a “silent” heart attack. Or the individual may have only one symptom, and it may feel a lot like previous heartburn experiences.
Even very experienced doctors can’t tell the difference just by looking at you or listening to your symptoms. A patient will need an EKG, blood tests, and sometimes a stress test or cardiac catheterization to be able to tell the difference. The rule in most emergency medical presentations is to assume the worst, which means the patient is treated as though they are having a heart attack until proven otherwise. This is prudent for the health of the patient as well as legal aspects for the physician and hospital.
Many studies have shown that people who die from heart attack erroneously believe they are suffering only from heartburn and take an antacid instead of calling 911. While there may not be anything wrong with taking an antacid, if you have a first episode of heartburn, a particularly bad episode of heartburn, unprovoked heartburn, or anything unusual about your heartburn, the best choice is to always call 911. Many people skip this step and instead drive themselves or are driven to the emergency room by a loved one, but this can be a lethal mistake. When one calls 911, paramedics are summoned which can bridge the gap in those precious minutes between your home and the emergency room when you are having a heart attack. These professionals can get an EKG of your heart, give you medication to dilate your coronary arteries and decrease the chance of heart muscle damage, give you oxygen, and care for you in case you would stop breathing.
In the end, only the individual involved can make the call about whether a heartburn episode may be a heart attack, but keeping in mind that even physicians cannot know without tests, it is better to err on the side of caution. Of course, if you have heartburn frequently, and heart problems have recently been ruled out, it may be more prudent to make an appointment with a gastroenterologist who can assess your situation and provide the appropriate care for your heartburn while monitoring your risk of developing heart problems, which will likely be referred to a cardiologist if they occur.
If ever in doubt, call 911. Time is of the essence.
[Featured Image by Joe Raedle/Getty Images]