a woman with heartburn pain

Is it a bad case of heartburn or the early symptoms of a heart attack? Years ago we heard about a person who convinced himself that the chest pain he was experiencing was probably just severe reflux. He ignored the symptoms for over a day. By the time he went to the ER irreparable harm had been done to his heart. Women may be even more susceptible to this deny and delay strategy.

Q. I read about the person who thought she suffered from heartburn, self-treated with antacids, and died in her sleep of a heart attack.  I can’t tell you how close I came to being such a victim.

I also thought I was suffering from an awful case of stomach ache with the pain up high under my breastbone. No heavy arms nor elephant-sitting-on-my-chest feeling. I, too, took antacids and found no relief.

At the Emergency Room I was diagnosed with esophagitis, given more antacids and sent home. The pain returned and persisted the rest of the week. I kept taking the prescribed antacids.

Then I had another bout of unbearable pain and was taken to the ER at a different hospital. This time I was told I was having a heart attack.

Please tell your readers the signs of a heart attack can include unbearable “stomach ache” high in the chest under the breast bone, aching jaws, and pain under the shoulder blade (back). It scares me that I was discharged from the first hospital as having just a stomach ache: I could have had a heart attack while driving my car to work or in front of my third-grade students at school!

A. Diagnosing a heart attack is a lot harder than most folks imagine. Here is the story you were referring to:

“My friend and co-worker didn’t like going to doctors. Last year, she thought she had heartburn for a few weeks. She took antacids and thought no more of it. Then she died in her sleep of heart problems. She was 51 years old, with grown children and grandchildren. What a tragic, preventable loss! If only she had gone to a doctor about her symptoms, she’d still be alive.

“I know that if I ever have an unusual case of heartburn, I’ll be quick to see a doctor.”

Women are more likely than men to experience symptoms that may be disregarded as digestive distress. Whereas a man may complain of chest pain (the elephant on the chest), pain radiating down the arm from the shoulders, neck or jaw and shortness of breath, women often sense discomfort in their upper body. It may manifest as pressure, nausea or back pain. A cold sweat and lightheadedness may sometimes be the only symptoms a woman notices. Even emergency physicians sometimes make mistakes when it comes to diagnosing heart attacks in women, as the person above noted.

If there is any question, go to the emergency room for an electrocardiogram and a blood test. It is important to remember that women do not always have classic symptoms of crushing chest pain, pressure on the chest, or pain down the left arm. Doctors sometimes discount women’s symptoms on the grounds that middle-aged women don’t get heart attacks as frequently as men. While true, that does not mean women don’t get heart attacks in their 40s or 50s. One of the more common mistakes that doctors make is failure to diagnose “acute coronary syndrome” including heart attacks. You can learn more about common diagnostic errors in our book, Top Screwups Doctors Make and How to Avoid Them.

Trust your instincts. If you think it is a possible heart attack, do not waste time. Emergency angioplasty, stent placement and clot-buster drugs save lives when initiated early during a heart attack!

Women and Heart Attacks:

We recently had the opportunity to interview two of the country’s leading female cardiologists, Drs. Rita Redberg and Viola Vaccarino. You cannot get more up-to-date information on women’s heart health. Remember, heart attacks remain the leading cause of death among women! You will want to listen to the one-hour show, “What Should Women Do to Protect Their Heart Health?Here is a link. Dr. Redberg is not one of those cardiologists who sees everything as a statin insufficiency. She offers great common sense advice for good health.

Share your own experience below in the comment section.

Revised, May 26, 2016.

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  1. Redsail

    One night, I awoke at 3am feeling like I had a half pound weight on my chest. Not really painful but just uncomfortable. I tried to walk it off and then managed to go back to sleep. Next day, I had symptoms again and decided to see a doc just in case.

    The EKG showed nothing and I was sent home. Eight hours later, I awoke with worsening chest discomfort. Hesitated about going to the emergency room since I had just been checked out, but when I broke into a cold sweat I knew I needed to go. They quickly confirmed a heart attack with the blood test.

    Later my cardiac rehab nurse said the first doctor should have done a blood draw to check the troponin level. I didn’t know to ask for it but I definitely will if I ever have symptoms again. Ended up with a stent and angioplasty. I’m a 72 year old female.

  2. SLA
    Austin, TX

    I had a heart attack three years ago at age 50. I am a woman with no history, and had gotten a clean bill of health just a year or so prior after routine stress tests and other cardio exams. I have GERD, so I was always afraid I wouldn’t know the difference between heartburn and a heart attack, and at first I didn’t, but the pain just got worse and worse over the course of the next 15 minutes or so. I also experienced the cold sweats, clamminess, and pain radiating down both arms and into my jaws. Still, I didn’t think it was a heart attack, because of the lack of history, etc. I’m glad I had my son call 911 anyway. They informed me I was having a “cardiac event,” and got me to the hospital right away. Turns out I had a blood clot that was totally blocking an artery. Got into the cath lab and got a stent put in right away, so there was no damage to my heart at all. It pays to pay attention to your symptoms! (I’m grateful mine were so obviously “something” wrong.)

  3. Carol
    Rice lake, WI

    I had a heart attack called SCAD (spontaneous coronary artery dissection). This hits mostly younger women (average age, 42 years) with no heart risk factors and physically very fit. Had I not been in the company of a nurse who insisted I go to the ER, I would have ignored the chest and back pain. I hope you do a program on SCAD. You will save lives. Dr Sharonne Hayes would be an excellent guest.

  4. John
    North Carolina

    This is a good warning for both men and women. While walking the dog over a year ago, I was coming up a long hill near our home and I felt a burning in my chest that I mistook for heartburn. I am usually very aware of what is going on with me physically from a workout regimen that I’ve been following for 40 years. I made it home and rested for a few minutes and the heartburn went away, something that in itself is a tell-tale sign. Heart burn doesn’t go away in a few minutes. It recedes slowly. It turned out that I had 90 percent blockage of the lateral descending artery and could have been one step away from death. Especially for those who are physically fit, denial plays a big role in interpreting the pain when experienced.

  5. MHW

    I was 49 years old and had heartburn around 2:00 am on Christmas morning. Simple antacids and belching a couple of times allowed me to go back to bed. By 7:00 am it had changed into a unusual pain high in my shoulders. Due to the strange nature of the pain and family history I went to ER where I was found to be having a heart attack. If in doubt, go get checked.

  6. CDM

    In 2013 while on vacation on a Caribbean Island, most nights, for a couple of hours, I experienced feelings of pins and needles in both arms that felt like poor circulation to me. I also had back tightness, blaming it on the hard mattress. During the day I felt fine.
    After returning home I went to emergency where blood tests and ECG revealed it was not my heart and was diagnosed as muscular related. The symptoms came and went and over the next week I had several chiropractic adjustments, finding little relief. Then the pain moved to my back and was constant.
    I assumed it was still muscular but after 3 sleepless nights and not being able to work,I returned to emergency. Blood tests and ECG showed I was experiencing (or had experienced) a heart attack. I had an emergency angioplasty where 2 stents were inserted into my right coronary artery as it was 100% blocked.
    I have been told by several doctors that blood tests do not show a heart attack until several hours after the heart attack commences. That was 16 months ago and now I am feeling better than I have in years after employing numerous alternative healing/recovery therapies, minimal medication and lifestyle changes like retiring from a stressful job. So this experience has a silver lining in that I have a more positive and optimistic outlook on life.

  7. Kate W

    DCwriter have you talked to a gastroenterologist about esophageal spasms? Fairly common for people who have GERD. My first spasm felt like a heart attack – pain radiating out from mid-chest. I was ready to go to the hospital but for some reason drank some ginger-ale first. Spasm went away immediately. Some people’s spasms are so bad they go to emergency. For me, carbonated drinks and chewing gum will get rid of the spasm. Otherwise a spasm will last about 30 min.

  8. DCwriter

    At 65, this is a concern of mine since I have chronic reflux (Barrett’s esophagus) and also arthritis in neck/upper body joints. I work on the computer constantly which adds muscle discomfort through arms and chest, even back.
    I’ve awakened in the middle of the night before feeling like I’d been run over by a truck. Even went to the ER several times years ago. All checked out okay. But with so many aches and pains to start with, I can only hope to recognize the difference if a heart attack should occur. Thankfully no heart disease in my family. I wish there were more distinct warning signs.

  9. Mike G.

    I had a good, guy friend die a number of years ago from this exact same problem where he thought he was suffering from heartburn went to the doctor and was prescribed heartburn medication.
    Later that night he suffered a major heart attack and died. He was only 47, had a wife and two kids and I think his wife ended up getting some kind of financial compensation for the misdiagnosis but I’m sure it seemed small vs. having their dad back!
    Apparently it is much more of a ‘common problem’ than I realized.

  10. Ruth C.

    Even men may not have the classic symptoms. My brother had a months worth of shoulder and elbow pain that we thought was due to lifting our mother who was nonambulatory. My dad had a “silent” MI which wasn’t found until much later when he experienced some chest pain.

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