close_game
close_game

Signs of heart attack that resemble gastric trouble; experts on how to differentiate between the two

By, New Delhi
Jun 07, 2023 09:37 AM IST

A person having heart attack may experience heart burn, chest pain, stomach ache, but may confuse these signs for gastric issues. Here's what experts say.

Heart burn or stomach ache could be a sign of heart attack and ignoring these symptoms may lead to dangerous consequences, as per experts. It is not uncommon for symptoms of gastric trouble and heart attack to overlap. A person having heart attack may experience heart burn, chest pain, stomach ache, nausea but may confuse these symptoms for gastric issues. In the state of confusion, the patient instead of rushing to the hospital, may take antacid which could even provide temporary relief, but delay the real treatment. This could prove to be deadly for the one having heart attack with the abovementioned symptoms. (Also read: 8 heart attack signs and symptoms people should not ignore)

It's common to see people misdiagnose a heart attack as gastric trouble and delay reaching hospital. In heart attack, time is very important (Shutterstock)
It's common to see people misdiagnose a heart attack as gastric trouble and delay reaching hospital. In heart attack, time is very important (Shutterstock)

It is important to know that in case of heart attack, the chest pain can feel like pressure, or squeezing in the chest lasting more than a few minute and it may come and go. The pain in case of heart attack may spread to shoulders, back, neck, teeth or jaw. Apart from these issues, one may also experience shortness of breath, panic attack, lightheadedness that are classic symptoms of heart attack.

Dr. Mukharjee Madivada, Senior Interventional Cardiologist, Managing Director, Pulse Heart Center. Director, Pulse Heart Charitable Trust, Founder - Ex President, IMA Kukatpally recently shared a case study on his Twitter handle where one of his patients - a diabetic and a smoker - took antacid for chest burning, while he was actually having a heart attack. After the burning partially subsided, the patient thought it was gastritis and delayed going to the hospital till the next day.

"Mr. KR had chest burning two days ago. He has diabetes and he smokes an occasional cigarette. His immediate fear was that he was having a heart attack. But he strongly believed that with his good genes he wouldn’t have a heart attack at 45 years. He wanted to go to the doctor, but before that he wanted to make sure that the pain was not due to gastritis. He drank an antacid syrup and a few minutes later the burning subsided partially. Relieved, he took rest from the office that day. He went to his family doctor the next day evening as he still had mild burning. His doctor took an ECG which showed a heart attack and he referred Mr. KR to me. I did an angiogram, fixed his block and he is stable now. But because he delayed the treatment for his heart attack for a day, his heart would never be the same: it will be weak. Reduction of chest pain partially or completely with antacids, is not a definitive evidence that the pain is due to "gas". It could still be heart-related. Most heart attacks mistaken for gastritis start with chest pain that partially responds favourably with antacids. This totally deludes the patient who is already in denial about having a heart disease. This advice is more pertinent for people with strong risk factors for heart attack like diabetes, smoking habit, etc …Mr. KR at least could reach the hospital. Some may not be so fortunate," wrote Dr Madivada on his Twitter handle.

How to differentiate between heart attack and gastric issues

"Adults with chest pain account for a large number of emergency department (ED) visits. Patients present with a spectrum of signs and symptoms reflecting the many potential etiologies. Diseases of the heart, aorta, lungs, esophagus, stomach, mediastinum, pleura, and abdominal viscera may all cause chest discomfort. Gas pain in the chest is usually described as a sharp or dull discomfort that may be accompanied by burping or flatulence. The pain is typically located in the upper abdomen or upper chest, and may radiate to the back or shoulder. Heart pain, on the other hand, is typically described as a squeezing or pressure sensation that may radiate to the jaw, neck, or arm. It is important to note that heart pain can be felt in the upper abdomen or upper chest, so it’s essential to distinguish between the two by considering other symptoms and risk factors," says Dr. Vivudh Pratap Singh, Senior Consultant, Interventional Cardiology, Fortis Escorts Heart Institute, Okhla Road, New Delhi.

"It's common to see people misdiagnose a heart attack as gastric trouble and delay reaching hospital. In heart attack, time is very important. Each passing minute, heart muscles get impacted. It's very important to understand difference between gastric trouble symptoms and heart attack symptoms. Many a time, it's difficult even for doctors to differentiate. Commonly a gas trouble is suspected when someone has burning in or pain in abdomen epigastrium or naval area. This discomfort gets aggravated by or related to eating unhealthy, spicy or masala food or due to empty stomach. The discomfort may radiate to back. Heart attack also can have Retrosternal burning or pain. It's more diffused in nature but generally it's not related with food intake and sometimes it may radiate to left or right arm or jaw area, associated with sweating and gets aggravated by activity and improves with taking rest," says Dr Bharat Vijay Purohit, Sr. Consultant Interventional Cardiologist & Director of Cath Lab, Yashoda hospitals Hyderabad.

"A heart attack occurs when the artery supplying blood to the heart becomes blocked. Angina is a similar chest pain that can be caused when these arteries are narrowed by cholesterol deposits. On the other hand, acidity or gastric problem is a burning pain often felt in the upper belly or lower chest. It is caused by gastric acid going back up the food pipe. Pain due to gastritis and heart attack pain can be similar. Sometimes identifying the difference between heart attack and gastric issues can be difficult because the symptoms are quite identical. Doctors often make a diagnosis based on symptoms as well as clinical tests as even doctors can find their symptoms difficult to understand," says Dr. Manmohan Singh Chauhan, Head of CTVS, Manipal Hospital, Gurugram.

Explaining the main difference between symptoms Dr Chauhan says:

• Gastric problems tend to be worse after eating and when lying down, but a heart attack can happen even before meals, though it can precipitate after meals.

• Gastric problems can be relieved by drugs that reduce acid levels in the stomach.

• Gastritis does not cause breathlessness, sweating or a feeling of impending doom.

If a person is experiencing any of the below symptoms, then an urgent medical intervention is required, says Dr Chauhan.

• Chest pain or discomfort, such as pressure, squeezing, pain, or fullness that lasts more than a few minutes or that goes away and comes back again.

• Pain or discomfort in other parts of the body, for example, one or both arms, back, jaw, neck, or stomach.

• Shortness of breath, before or with chest discomfort.

• Cold sweat

• Nausea and dizziness

• Other signs: Feeling unusually tired

What to do in case of confusion

"Generally heart related discomfort does not happen below the naval area. If in doubt regarding heart or gastric trouble it's better to do ECG or Troponin, Echocardiogram and last but not least an Angiography to clarify. Most important is trust your doctor and co-operate in investigation to ascertain cause of discomfort. An overdiagnosis and some extra tests are better then underdiagnosis and missing a heart attack and passing it off as gastric trouble," says Dr Purohit.

"20-40% of people visit a GP at least once in their lifetime with the complaint of chest pain.

While any chest pain should raise the suspicion of a heart related pain called angina about 15% have chest pain because of dyspepsia due to gastritis gastric reflux or indigestion. It’s often a challenge for practitioners to differentiate between the two. In most cases if the chest pain gets worse on exertion, if it’s located centrally behind the breast bone, if it's squeezing or pressing associated with sweating, it indicates a heart related pain. If it’s associated with burping due to heavy meal and unrelated to exertion, and is if burning type it may indicate heartburn due to hyper-acidity. Having said that there is considerable overlap and often both problems can co-exist. So what is important is to have a high index of suspicion for ruling out heart attack. Heart related pain is a serious condition and needs to be recognised and treated promptly. Often it may be a precursor for a heart attack and if ignored may be life threatening," says Dr. V. Rajasekhar, Senior Consultant Interventional Cardiologist & Electrophysiologist, Certified Specialist for TAVR (Percutaneous Trans Aortic Valve Replacement), Yashoda Hospitals Hyderabad.

"Once the person is in an emergency with these symptoms, an ECG or Echocardiography is done for diagnosis. Other investigations such as X-rays, blood tests or angiography might also be done depending on the condition of the patient. For heart attacks, percutaneous coronary intervention (PCI) is one form of treatment. A device, such as a balloon, is used to widen the narrowed artery and improve flow through it. A mesh tube, known as a stent, may be left in place, to keep the vessel open," says Dr Chauhan

Catch every big hit, every wicket with Crick-it, a one stop destination for Live Scores, Match Stats, Quizzes, Polls & much more. Explore now!.

Catch your daily dose of Fashion, Taylor Swift, Health, Festivals, Travel, Relationship, Recipe and all the other Latest Lifestyle News on Hindustan Times Website and APPs.
See More
Catch every big hit, every wicket with Crick-it, a one stop destination for Live Scores, Match Stats, Quizzes, Polls & much more. Explore now!.

Catch your daily dose of Fashion, Taylor Swift, Health, Festivals, Travel, Relationship, Recipe and all the other Latest Lifestyle News on Hindustan Times Website and APPs.
SHARE THIS ARTICLE ON
SHARE
Story Saved
Live Score
Saved Articles
Following
My Reads
Sign out
New Delhi 0C
Wednesday, February 19, 2025
Start 14 Days Free Trial Subscribe Now
Follow Us On