How to differentiate heart attack pain from acidity pain

Chest pain is a common symptom. It may be due to multiple reasons ranging from simple muscle pain to heart attack. Heart attack related chest pain is commonly confused with acidity-related chest discomfort. Though we cannot differentiate the two pains with 100% surety, here are some pointers that will help in predicting heart related pain and reaching out to healthcare facilities early.

1. SITE OF PAIN

The chest pain related to the heart can occur anywhere between the epigastric region (Region above the umbilicus) and the throat. The usual location will be in the central chest.  Sometimes left-sided and occasionally right-sided.  Usually associated with pain in the left shoulder and left arm. Sometimes it can appear as throat pain which increases while walking. Though acidity related pain also occurs in the same site the radiation of pain to the left shoulder or hand is not commonly observed.

2. ASSOCIATED SYMPTOMS

The chest pain related to the heart may be associated with sweating, vomiting, and unusual tiredness. Another very important associated symptom is breathing difficulty while walking. Pain-related to gastric problems may be associated with vomiting but usually no breathing difficulty.

3. FACTORS THAT INCREASE OR DECREASE THE PAIN

Usually, the chest pain related to blocks in heart can happen in two ways:

1. When the block is less than 80-90% patient may experience chest pain during walking or climbing up stairs or while lifting heavyweight. When the patient takes rest or stops walking the chest pain will come down within 5 to 10 min.

2. When there is total blockage of the blood vessels, patients will experience symptoms even during rest. Also pain will not come down within 10 mins of rest. It will be continuous. The chest pain is nothing but crying of the dying heart muscle. So whenever there is ongoing chest pain associated with sweating or vomiting or tiredness it may be a symptom of major heart attack.

Pain related to gastric problems are usually aggrevated during fasting or after having spicy food. It is not related to physical activity.

4. ASSOCIATED RISK FACTORS

If the person having chest pain has the following risk factors then the pain is more likely to be heart related than being a simple acidity as these comorbidities increase the chances of  cholesterol deposits in heart vessels and heart attack.

• Family history of premature heart disease (father or brother before the age of 55yrs or Mother or sister before the age of 65yrs had a heart attack or underwent stenting or bypass surgery)
• History of long-standing diabetes or high BP or high cholesterol
• Smoking habit
• Sedentary lifestyle
• Unhealthy dietary habits

To summarise, anyone with risk factors for heart problems should be very careful and not ignore chest pain especially when it is associated with breathing difficulty or pain increases with physical activity or when the ongoing chest pain is associated with shoulder pain or throat pain. 5 to 10% of patients may not have the classical chest pain symptoms as described above and hence it is very important to consult a doctor in case of doubt.