Heartburn
| Heartburn | |
|---|---|
| Synonyms | pyrosis, cardialgia |
| Classification and external resources | |
| Specialty | Gastroenterology |
| ICD-10 | R12 |
| ICD-9-CM | 787.1 |
| MedlinePlus | 003114 |
| MeSH | D006356 |
Heartburn, also known as acid indigestion, is a burning sensation in the central chest or upper central abdomen. The pain often rises in the chest and may radiate to the neck, throat, or angle of the jaw.
Heartburn is usually due to regurgitation of gastric acid (gastric reflux) into the esophagus and is the major symptom of gastroesophageal reflux disease (GERD). In about 0.6% of cases it is a symptom of ischemic heart disease.
The terms indigestion includes heartburn along with a number of other symptoms. Indigestion is sometimes defined as a combination of epigastric pain and heartburn. Heartburn is commonly used interchangeably with gastroesophageal reflux disease rather than just to describe a symptom of burning in one's chest.
Heart attack symptoms and esophageal symptoms can be very similar, as the heart and esophagus use the same nerve supply.
Because of the dangers inherent in an overlooked diagnosis of heart attack, cardiac disease should be considered first in people with unexplained chest pain. People with chest pain related to GERD are difficult to distinguish from those with chest pain due to cardiac conditions. Each condition can mimic the signs and symptomatic findings of the other. Further medical investigation, such as imaging, is often necessary.
Symptoms of heartburn can be confused with the pain that is a symptom of an acute myocardial infarction and angina. A description of burning or indigestion-like pain increases the risk of acute coronary syndrome, but not to a statistically significant level. In a group of people presenting to a hospital with GERD symptoms, 0.6% may be due to ischemic heart disease.
As many as 30% of chest pain patients undergoing cardiac catheterization have findings which do not account for their chest discomfort, and are often defined as having "atypical chest pain" or chest pain of undetermined origin. According to data recorded in several studies based on ambulatory pH and pressure monitoring, it is estimated that 25% to 50% of these patients have evidence of abnormal GERD.
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