How do you know if it's gastric pain or heart pain?

September 30, 2025 •

4 min read

Chest pain is the second most common reason for adults visiting the emergency department in the United States, yet over half of these visits have non-cardiac causes. It can be incredibly difficult to know if it's gastric pain or heart pain, and mistaking indigestion for a heart attack, or vice versa, can have serious consequences.

Quick Summary

Differentiating between gastric and heart-related pain requires careful attention to symptoms like the nature and location of discomfort, triggers, and other associated signs. Key differentiators include the pain's quality (burning versus pressure), whether it radiates, and if it is relieved by antacids or rest. Prompt medical evaluation is critical for any new or severe chest pain.

Key Points

Location and Nature of Pain: Heart pain often feels like a squeezing pressure in the center of the chest, possibly radiating to the arms, back, neck, or jaw; gastric pain is typically a burning or sharp sensation in the upper abdomen.
Associated Symptoms: Heart pain is frequently accompanied by shortness of breath, cold sweats, nausea, and dizziness, while gastric pain may involve bloating, belching, or a sour taste.
Triggers: Heart pain (angina) is commonly triggered by physical exertion or emotional stress, whereas gastric pain is often related to eating, lying down, or bending over.
Response to Treatment: Gastric pain can sometimes be relieved by antacids, passing gas, or changing position; heart pain is generally not and requires rest or medication.
When in Doubt, Seek Help: Given the potential severity of a cardiac event, it is crucial to seek emergency medical attention immediately for any unexplained, new, or severe chest pain, especially if risk factors are present.

The Overlap: Why Gastric and Heart Pain Are So Confusing

Many people experience chest discomfort that leaves them wondering about its cause. Conditions affecting the esophagus and stomach, like acid reflux (heartburn) and gastritis, can produce symptoms that closely mimic a heart attack or angina (chest pain due to reduced blood flow to the heart). This anatomical proximity means a person can feel a burning sensation from stomach acid or a squeezing pressure from a cardiac event in the same general area—the chest.

Understanding Gastric Pain and Its Variations

Gastric pain arises from the digestive system and can be caused by several conditions. The nature of the pain is often linked to eating habits or body position.

Common causes of gastric pain include:

Acid Reflux and GERD: When stomach acid flows back into the esophagus, it causes a burning sensation (heartburn) that can be felt in the chest.
Gastritis: Inflammation of the stomach lining can cause a gnawing or burning ache in the upper abdomen.
Gas: Trapped gas in the digestive tract can cause sharp, stabbing, or cramp-like pain in the chest or abdomen.
Peptic Ulcers: Open sores on the stomach lining can produce a burning sensation that may feel better after eating but worsens on an empty stomach.

Understanding Heart Pain and Cardiac Symptoms

Cardiac pain is a symptom of a heart condition, most critically a heart attack or angina. A heart attack occurs when blood flow to the heart muscle is severely reduced or blocked, and it is a medical emergency.

Common symptoms of a heart attack include:

Chest Discomfort: Often described as a feeling of pressure, tightness, squeezing, or fullness in the center or left side of the chest.
Pain Radiation: The discomfort can spread to other areas of the upper body, such as one or both arms, the back, neck, jaw, or stomach.
Associated Symptoms: Shortness of breath, cold sweats, nausea, lightheadedness, or sudden dizziness may accompany chest pain.
Duration: Heart attack pain typically lasts for more than a few minutes or may go away and come back.

How to Differentiate Gastric and Heart Pain

Knowing the specific characteristics of your pain can help determine its origin. However, it is crucial to remember that these are not definitive diagnostic tools. When in doubt, always seek immediate medical attention.

Key Differences in Pain Characteristics

Nature of the Pain: Gastric pain, like heartburn, is often a burning sensation, while heart pain is typically described as pressure or squeezing.
Location: Gastric pain is usually concentrated in the upper abdomen or lower chest area. Heart attack pain is more centrally located in the chest but can be felt broadly.
Radiation: Heart attack pain often radiates to the arms (especially the left), jaw, neck, or back. Gastric pain is generally more localized, though severe heartburn can travel toward the throat.
Triggers: Gastric pain is frequently triggered by eating a large or spicy meal, lying down, or bending over. Heart pain (angina) is more commonly triggered by physical exertion or emotional stress.
Relief: Gastric pain may be relieved by antacids, belching, or passing gas. Heart pain is not relieved by these methods but may briefly improve with rest.

Comparison Table: Gastric Pain vs. Heart Pain


Feature	Gastric Pain (e.g., heartburn)	Heart Pain (e.g., heart attack)
Nature of Pain	Burning, sharp, cramp-like, gnawing	Pressure, tightness, squeezing, fullness, crushing
Location	Upper abdomen (epigastric), lower chest	Center or left side of the chest, broad area
Radiation	May travel up the throat, can be localized	Often spreads to arms, back, neck, jaw, or shoulder
Triggers	Large or spicy meals, lying down, bending over	Physical exertion, emotional stress, cold weather
Relieved by	Antacids, belching, passing gas, changing position	Rest, but may not resolve completely
Associated Symptoms	Bloating, belching, gas, sour taste in mouth	Shortness of breath, cold sweats, nausea, lightheadedness
Duration	Can be intermittent, often resolves with digestion	Lasts more than a few minutes, may come and go

When to Seek Emergency Medical Attention

Because the signs can be so similar, healthcare providers emphasize that it is always safer to assume chest pain could be cardiac and seek emergency care. Do not attempt to self-diagnose, especially if you have existing risk factors for heart disease.

You should call 911 immediately if your chest pain is accompanied by any of the following:

Sudden, severe, or worsening pain that lasts more than a few minutes.
Pain that radiates to your arm, back, neck, or jaw.
Shortness of breath.
Cold sweats, nausea, or dizziness.
Pain that occurs with physical activity and resolves with rest.
You have known risk factors for heart disease (e.g., high blood pressure, high cholesterol, smoking, family history).

Conclusion: Prioritizing Your Health

While the difference between gastric and heart pain can be subtle, understanding the classic distinctions in pain type, location, and triggers can provide valuable clues. However, due to the high stakes of a cardiac event, the best approach is to err on the side of caution. Never hesitate to seek immediate medical help for any unexplained or severe chest pain. Timely intervention is critical for heart attacks and can be life-saving. Your doctor or an emergency medical team can perform diagnostic tests, such as an electrocardiogram (EKG) or blood tests, to determine the true cause of your chest pain and provide appropriate treatment. For further reading on heart attack symptoms, the CDC offers comprehensive information.

Frequently Asked Questions

Yes, it can. Trapped gas in the digestive system can cause chest pain and pressure that is sometimes mistaken for a heart attack, causing confusion due to the overlapping symptoms. However, gas pain is usually associated with other digestive issues like bloating and belching.

While heart pain is more likely to radiate, severe heartburn can sometimes cause a burning sensation that travels toward the throat. However, it is not common for gastric pain to radiate to the arms, jaw, or back in the way cardiac pain often does.

Gastric pain, like gas or heartburn, can be intermittent and often resolves after a short time with digestion, passing gas, or taking an antacid. Heart pain, such as from angina or a heart attack, often lasts for more than a few minutes and may come and go.

The biggest warning signs include chest pain that feels like squeezing or pressure, pain that spreads to the arms, back, neck, or jaw, shortness of breath, a cold sweat, and nausea. If these symptoms occur, call emergency services immediately.

While an antacid might help with indigestion, it is not recommended to use it as a diagnostic tool. If the pain persists for more than 15 minutes or is severe, you should not wait to see if the antacid works. Seek immediate medical attention to rule out a heart condition.

Yes, emotional stress and panic attacks can cause chest tightness, pressure, or discomfort, along with other symptoms like a racing heart and difficulty breathing. However, because it is difficult to distinguish from a heart attack, any severe or unexplained chest pain warrants a medical evaluation.

Yes. While chest pain is the most common symptom for both, women are more likely than men to experience atypical symptoms like shortness of breath, fatigue, and pain in the back, neck, or jaw without significant chest discomfort.