Dr. Bikram Kesharee Mohanty Director& ChiefCardio Thoracic & Vascular Surgeon (Adult & Paediatric), Venkateshwar Hospital, Dwarka, New Delhi
When we listen to the terminologies ‘Heartburn’ and ‘Heart pain’, they sound so similar that we usually think that they occur because of problems in our hearts. However, they are like opposite sides of the same coin: Similar yet completely different. They have similarities in presentation but are completely different so long as implications are concerned. This poses a great diagnostic dilemma for the patient as well as for the general practitioner.
HEARTBURN
Heartburn has nothing to do with the heart, though the name suggests so. It’s actually because of some issue in the stomach. It is otherwise known as acidity or hyperacidity. Acids are secreted in the stomach for the digestion of food. However, when there is excessive acid secretion, over and above the normal it irritates the stomach musculature thereby causing chest pain.
HEART PAIN
Unlike heartburn, heart pain which is otherwise known as Angina is true because of a problem in the heart. Remembering the very fact that the heart is a pump that pumps blood throughout the body. Blood is the carrier that transports oxygen and nutrients etc, throughout the body because every part of the body is living tissue and they require blood for the sustenance of life. Though the heart does this act of pumping for the whole body, it also requires blood (nutrients and oxygen etc.) for its own survival. There are many arteries (tubular structures) that carry blood to the heart muscles. Blockages in these arteries of the heart cause the inadequate blood supply to the heart muscles thereby causing angina or chest pain.
| HEARTBURN (Hyperacidity) | HEART PAIN (Angina) | |
| Symptoms | Burning or discomfort in central or upper chest in empty stomach or immediately after a meal. | Chest pain, discomfort, squeezing, constriction in central or left side of chest radiating to jaw, left shoulder or left arm. Associated with sweating, breathlessness. |
| Causes | Excessive acid secretion. | Blockages in heart arteries. |
| Risk factors | Citrus, spicy food, smoking, excessive tea, coffee or alcohol. | High blood pressure, diabetes, overweight, sedentary lifestyle, tobacco, excessive alcohol, hereditary. |
| Aggravating Factors | Fasting and consumption of risk factors. | Excessive exercise, stress, having risk factors. |
| Relieving Factors | Water, cold milk, antacids. | Taking rest from exercise, aspirin, nitroglycerin. |
| Complications | GERD (Gastro Esophageal Reflux Disease ) | Heart attack, heart failure, depressed heart function. |
| Precautions | Frequent small meals, avoid risk factors. | Periodic heart check up, control and treatment of risk factors. |
| Diagnosis | Consultation with physician, gastro- entologist, endoscopy. | Cardiac check up, angiography. |
| Treatment | Anti acid medicines and treatment as per complication. | Cardiac medicines, Angioplasty, Bypass surgery. |
| When to see a doctor | Repeated, severe heartburn, not responding to the above treatment. | If any sign of angina. |
It is imperative and important to know the two sides of the coin thereby preparing oneself to avoid a life-threatening situation.
