A burning sensation in the chest during physical exertion can signal a dangerous heart attack rather than routine acid reflux or heartburn.
“Heartburn and heart attack symptoms can be very similar and sometimes indistinguishable,” said Dr. Sara Khodor, an interventional cardiologist with Health First.
Clinical presentations vary widely. Patients frequently describe tightness, burning, pressure, or a heaviness sensation similar to an elephant sitting on the chest.
“The textbook description is a pressure or a heaviness sensation,” Khodor said.
Discomfort can radiate to the jaw, shoulders, arms, or back. Physical activity often triggers these warnings.
“Anything with exertion, I would be concerned about cardiac disease,” Khodor said.
Taking an antacid may offer temporary relief even when the heart is in distress. Physicians warn patients against assuming a clear bill of health simply because an over-the-counter remedy reduces the burning.
“Relief of symptoms with antacid should not exclude a heart attack or heart disease,” Khodor said.
Women, older adults, and people with diabetes may experience less obvious signs. These include unusual fatigue, shortness of breath, nausea, vomiting, sweating, or dizziness, without feeling classic chest pain.
“I’ve had patients who come in saying they’re just really fatigued with exertion that’s not usual for them and not necessarily pain in the chest,” Khodor said.
BJ Throop, an avid dek hockey goalie from McKees Rocks, experienced a burning chest sensation while playing in a championship game on his 53rd birthday last September, WPXI reported.
“I didn’t have any of the normal symptoms that a person has related with a heart attack – the chest pain,” Throop said.
“Pain going into your jaw, the numbness in your arm,” Throop said.
“I’d been having a burning in my chest, and I didn’t think nothin’ of it, you know, acid reflux,” he told WPXI. “I got home, and I was still having it, and I couldn’t get comfortable, no matter what I did, sitting down.”
Throop, a former EMT, went to Allegheny General Hospital. Medical staff determined his acid reflux sensation stemmed from a STEMI heart attack, inserting two stents that evening and a third months later. Throop urges others to take unusual symptoms seriously.
“We see people come in with heart attacks every day, and the presentations can be very different,” said Dr. Moneal Shah, an AHN cardiologist who treated BJ.
“It could be a burning, it could be nausea, it could feel like something almost in the abdomen… sometimes people just don’t feel well, it could be even as nonspecific as that,” Shah said.
Shah said a burning sensation occurring after a spicy meal points toward acid reflux, but a sudden burning sensation at rest or accompanied by exertion requires medical evaluation.
“If, however, you feel a burning sensation with exertion and you get some discomfort, that could be concerning for the heart,” Shah said.
Khodor said she regularly treats patients in their 40s and has seen cases in patients as young as 30.
“I’ve had plenty of patients in their 40s and I consider that very young,” Khodor said.
Anyone experiencing persistent, new, or concerning discomfort should seek immediate medical assistance rather than waiting or attempting self-diagnosis at home.
“If someone is experiencing persistent chest pain, they should seek emergency care so treatment can be escalated quickly,” Khodor said.
“You know your body better than anybody; if something’s wrong, go to the hospital, get checked,” Throop said.