Can acid reflux be a heart problem? A cardiologist and gastroenterologist explain how to tell the difference

Chest discomfort from acid reflux can resemble heart problems due to shared nerve pathways. Consultation is critical for accurate diagnosis and treatment.

Acid reflux and heart problems can feel very similar to each other because they both cause chest discomfort. However, understanding the distinction between them helps prevent unnecessary panic and ensures timely treatment if heartburn is a symptom of a heart issue.

Can acid reflux feel like a heart problem?

But the question that arises is: can acid reflux feel like a heart problem? According to Dr Ajit Menon, director of the department of cardiology at Sir HN Reliance Foundation Hospital, and Dr Geeta Malkan-Billa, director of gastroenterology and hepatology at Dr LH Hiranandani Hospital, yes, it can.

In an interview with HT Lifestyle, Dr Ajit clearly stated that acid reflux can closely mimic heart pain because the oesophagus lies directly behind the heart. “Both can cause discomfort in the centre of the chest, making the distinction difficult, often for both patients and physicians,” he explained.

Acid reflux usually feels like a sour taste in the mouth with burning in the throat.

According to Dr Ajit, it’s usually acid reflux when there is a burning sensation behind the breastbone, often described as heartburn. Symptoms may occur after a spicy or fatty meal, or when there is a sour taste in the mouth, belching or regurgitation of food into the mouth. “Symptoms improve with antacids, and there may be some bloating and a feeling of food coming back up,” he added.

Symptoms that indicate acid reflux, according to Dr Geeta:

• Burning sensation, coming upwards from the stomach to the throat area
• Sour/bitter taste or regurgitation
• Appearing shortly after a meal, especially after heavy, fatty, and spicy foods
• Aggravated by bending or lying down
• Improved with antacid medications

Meanwhile, one should treat this burning sensation or heartburn as heart-related pain if it usually occurs with exertion or walking, Dr Ajit cautioned. He further emphasised that if the discomfort spreads to the throat, both arms, or the jaw, and you feel a lump or a choking sensation, it can be related to your heart.

Pressure, pressing, tightness, or a weight sensation, rather than burning, could be heart-related rather than just acid reflux.

“Sometimes this sensation comes with breathlessness, sweating, etc. You should always consider that it could be cardiac-related, especially in those patients who have a high cardiovascular risk score, such as those with diabetes, high blood pressure, chronic smokers and high cholesterol,” he added.

Dr Geeta, too, highlighted the symptoms that indicate a heart condition as follows:

• Pressure, pressing, tightness or a weight sensation instead of burning
• Pain radiating to the arm, shoulder, jaw, neck, or back
• Triggered by physical activity/stress, which is relieved by rest
• Difficulty breathing, cold sweats, nausea, dizziness or excessive fatigue

When should you go to the ER immediately and consult a cardiologist?

According to Dr Geeta, one should visit the ER immediately or consult a cardiologist if:

• The chest pain is new, severe, or persists for a few minutes
• There are any of the heart condition-related symptoms accompanying it
• You have risk factors like being over 40 years old, smoking, diabetes, hypertension, high cholesterol levels or a family history of heart disease

Dr Geeta further cautioned that one should not consider an absence of heart problems if it was relieved with antacids. “Heart pain can start and stop suddenly without any particular cause. Sometimes women, elderly people, and patients with diabetes may experience milder or unusual symptoms of a heart attack, such as digestive system upset or feeling tired with vomiting and nausea,” she added.

When you experience repeated chest pain, do not hesitate to consult your physician.

Dr Ajit further added, “We often face the situation where the patient has been sitting at home, complaining of acidity, trying various medications, and, surprisingly, once in a while, even doctors mistake these symptoms for acidity. It’s only later, when the ECG is done, that you realise that the patient has already had a heart attack.”

According to him, heart attack pain may also not be limited to the chest: “Sometimes it can occur in the upper part of the stomach, where patients can have this discomfort. Usually, it’s on walking, or it’s worse on lying down and better on sitting up.” Moreover, even belching can be a symptom of a cardiac problem. “It would be surprising to note that belching occurs due to chest discomfort. Patients often feel better after belching, and it’s often disregarded. These patients can progress to have a major cardiac event,” he explained.

What should you do?

When there is any uncertainty about whether you have heart-related pain or just acid reflux, Dr Ajit suggests getting an ECG or appropriate blood tests, such as Troponin I. According to him, they can be used to distinguish between cardiac and acid reflux symptoms. “If you have a high risk for cardiovascular disease, it is always better to get investigated if you have these symptoms, which are persistent,” he added.

Meanwhile, Dr Geeta suggested, “When you experience repeated chest pain, do not hesitate and consult your physician regardless of whether you think that it is only heartburn. With the help of ECG and a couple of other tests, your heart will be examined, and only then will reflux disease be successfully treated. So, the bottom line is that if there is any similarity, rule out a heart problem first. Heart problems can kill you, but acid reflux cannot.”

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.