Understanding GERD and chest pain symptoms

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With cardiac chest pain, a person may feel the following sensations in their chest:

• pressure
• squeezing
• heaviness
• fullness
• tightening
• aching
• burning

Learn more about the symptoms of a heart attack here.

In contrast, GERD chest pain tends to feel like an intense stabbing or burning sensation just beneath the skin’s surface.

Cardiac chest pain may also worsen with movement and heavy breathing, whereas heartburn will typically not worsen with exertion.

Accompanying symptoms

The symptoms accompanying chest pain can be an important indication of whether it is cardiac or noncardiac.

The symptoms that can occur along with cardiac chest pain may include:

• shortness of breath
• irregular heartbeat
• dizziness or lightheadedness
• numbness
• pain or discomfort in other parts of the body, such as the arms, neck, jaw, shoulders, and back

Symptoms that indicate that the chest pain is from heartburn or GERD can include:

• pain or difficulty swallowing
• bloating
• belching or hiccups
• bad breath
• a sore or irritated throat
• an unpleasant or sour taste in the mouth

The location of chest pain may help indicate its cause, but this does not always allow for the differentiation of types of pain.

Location of GERD pain

Acid reflux occurs when stomach acid leaks into the food pipe or esophagus. One of the most common symptoms of acid reflux is heartburn–a painful burning sensation in the center of the chest just behind the breastbone or sternum.

Heartburn tends to remain localized, meaning that it does not spread to other areas. Heartburn typically develops behind or underneath the breastbone.

Other symptoms of acid reflux and GERD can include:

• a sour or bad taste in the mouth
• bad breath
• tooth decay
• difficulty swallowing
• nausea and vomiting
• a hoarse voice

Is it a heart attack?

A common symptom of a heart attack is pain or discomfort that typically occurs in the center or left side of the chest. This pain may come and go, and its severity can range from mild to severe. It can also sometimes feel like heartburn or indigestion.

However, not everyone who has a heart attack experiences chest pain. The symptoms of a heart attack can vary considerably from person to person, and they may come on slowly or very suddenly.

Other symptoms of a heart attack might include:

• intense pressure or tightness in the center of the chest
• a feeling of heaviness or weakness in one or both arms
• pain, numbness, or a tingling sensation in the arms, neck, jaw, lips, or stomach
• difficulty breathing or shortness of breath
• nausea and vomiting
• dizziness or lightheadedness
• fatigue
• breaking out in a cold sweat

Anyone who suspects that they or someone else is having a heart attack should immediately call 911 or go to the emergency room.

There are several other causes of chest pain. While many of these relate to heart function, disruption in muscle tissues, digestive systems, and many other body areas can cause pain in the chest.

Other causes of noncardiac chest pain

Causes of noncardiac chest pain can include:

• Pneumonia: Pneumonia is a chest infection that causes the tiny air sacs inside the lungs to become inflamed and fill with fluid. It may cause chest pain, difficulty breathing, and shortness of breath, among other symptoms.
• Peptic ulcer: A peptic ulcer is an open sore in the stomach lining or small intestine. Peptic ulcers can cause a painful burning sensation that starts in the abdomen and extends to the chest.
• Costochondritis: Costochondritis is an inflammation of the cartilage around the breastbone. This inflammation can cause tenderness and sharp chest pain that may feel similar to the pain of a heart attack.
• Esophageal spasms: Involuntary spasms or contractions of the food pipe can cause intense chest pain. These spasms can come on suddenly and sometimes last for several hours.
• Panic attacks: A panic attack refers to a sudden attack of intense anxiety and fear. They can cause chest pain, a rapid heartbeat, shaking, and shortness of breath.

Other causes of cardiac chest pain

Causes of cardiac chest pain can include:

• Angina: Coronary artery disease (CAD), also called ischemic heart disease or coronary heart disease, occurs when fatty deposits build up in the arteries, blocking blood supply to the heart muscle.
• Myocarditis: Myocarditis is a rare form of cardiovascular disease that causes inflammation of the heart muscle. This inflammation can lead to chest pain, heart failure, or sudden death.
• Hypertrophic cardiomyopathy: Hypertrophic cardiomyopathy (HCM) is a thickening of the muscle wall in the heart. It can cause chest pain, shortness of breath, and heart palpitations.
• Pulmonary hypertension: Pulmonary hypertension refers to high blood pressure in the arteries that supply the lungs. Common symptoms include shortness of breath and chest pain, which may occur or worsen with physical activity.

Both GERD and a heart attack can cause pain in the chest. GERD pain tends to be more central, while pain from a cardiac event will typically start in the left of the chest. The two conditions are also typically accompanied by different additional symptoms.

A heart attack is a medical emergency, so being able to tell the difference between heartburn and cardiac chest pain is crucial. If chest pain spreads to other areas of the body, such as the arms or jaw, or occurs alongside symptoms such as shortness of breath and a feeling of tightness in the chest, it might be a sign of a heart attack.

A person who suspects that they or someone else is having a heart attack should immediately call 911 or go straight to the emergency room. It is also advisable to see a doctor about any unexplained chest pain, even if it goes away on its own.