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Heartburn and Heart Pain in the Elderly

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Heartburn and Heart Pain in the ElderlyChest pain in seniors is always a cause for concern as they are at a greater risk of serious conditions like a heart attack. Although pain in the chest can be associated with the airways, lungs and even the large blood vessels connected to the heart, the two types of chest pain that are commonly confused is pain in the esophagus (food pipe) and heart. These organs are located next to each other and at times it is difficult to differentiate pain at either location.

Indeed, heartburn due to acid reflux (GERD) into the esophagus is one of the most common reasons for emergency room visits where it is often mistaken for a heart attack by the patient. Similarly, cardiac (heart) pain is at times passed off as heartburn especially when it lacks the typical characteristics of a heart attack. Therefore it is essential that seniors particularly those with coronary artery disease and other risk factors take any chest pain seriously and seek immediate medical attention.

Reasons for Heartburn and Heart Pain

Many people are confused about the terms heartburn and cardiac (heart) pain. The main cause for this confusion is that the term heartburn seems to refer to the heart. However, heartburn does not involve the heart in any way. Heartburn is a burning chest pain of the esophagus – the food pipe that connects the throat to the stomach. Acid should be contained within the stomach which has mechanisms to deal with it. Sometimes the acid leaks upwards into the food pipe and irritates the lining of the esophagus. This causes the typical sensation known as heartburn.

Cardiac pain is a broad term for any pain the heart. The most common cause of cardiac pain is ischemic pain. This means that the blood supply or oxygen levels to the heart tissue is insufficient and is therefore experiencing injury. This is a result of blocked arteries that’s supply the heart muscle – coronary artery disease. A heart attack occurs when the blood supply is compromised for too long and a portion of the heart tissue dies. There may be other types of cardiac pain but these are not as common as ischemic pain and often vary significantly in nature so as not to be mistaken for heartburn.

Differences between Heartburn and Heart Pain

There are certain features that can be useful in differentiating between heartburn and heart pain.

  • Heartburn is usually a burning chest pain while heart pain is generally a crushing or suffocating chest pain.
  • Heartburn is relieved by antacids while ischemic heart pain is eased by nitrates.
  • Heart pain is also accompanied by difficulty breathing, excessive sweating and dizziness. This is absent in heartburn.
  • Heart pain tends to radiate down the arm (usually left arm), to the neck or jaw or to the abdomen.
  • Heartburn may be accompanied by intense nausea and a sour taste in the mouth.
  • Heart pain is brought about my physical activity and psychological stress while heartburn worsens after eating and with bending over. Both types of pain may have common triggers though.
  • Heart pain may lead to fainting spells which does not happen with heartburn.

Despite these features, it is best not to attempt to self diagnose and always seek professional medical advice. This is especially true for the elderly who are at risk of having a sudden and severe coronary which can be fatal if early treatment is not initiated.


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