Is it gas or a heart problem? Cardiologist shares the warning signs of chest discomfort you should not ignore

Chest discomfort is commonly blamed on acidity, gas or indigestion. While digestive problems are frequent, assuming that every episode of chest discomfort is “just gas” can sometimes be dangerous. Heart-related symptoms can overlap with acidity , and in a cardiac emergency, recognising the warning signs and seeking timely medical care can be lifesaving. In an interview with HT Lifestyle, Dr Sunil Kumar Mandal, MBBS, MD (General Medicine), DM (Cardiology), senior consultant interventional cardiologist and head of cardiology, revealed signs and symptoms you shouldn’t ignore.

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Dr Sunil highlighted that the heart and upper digestive tract are located close to each other and share overlapping nerve pathways. As a result, reduced blood flow to the heart may not always produce the classic crushing chest pain people expect. “It can sometimes feel like pressure, heaviness, burning, tightness or simply an unusual discomfort in the centre of the chest—symptoms that may easily be mistaken for indigestion,” added Dr Sunil.

“ Chest pain is more concerning when it feels like pressure, squeezing, heaviness or tightness, particularly if it lasts more than a few minutes, keeps returning, or occurs with certain physical activity or emotional stress,” highlighted Dr Sunil. Chest pain that radiates to the left or both arms, upper back between the shoulder blades, neck or jaw should raise suspicion.

Associated symptoms are equally important. Shortness of breath, cold sweating, nausea or vomiting, dizziness, unusual weakness or a feeling of impending doom alongside chest discomfort warrant urgent attention.

Dr Sunil emphasised that heart attacks do not always follow the textbook pattern. Women, older adults and people with diabetes may have subtle symptoms, including unexplained breathlessness, profound fatigue, nausea, upper abdominal discomfort or back and jaw pain, sometimes without significant chest pain.

“Unfortunately, there is no foolproof home test. Acid reflux more commonly causes a burning sensation after meals or while lying down and may be accompanied by sour taste or regurgitation,” said Dr Sunil. But these features cannot reliably exclude a heart problem. A common mistake is assuming that improvement after an antacid proves the discomfort was gastric. Symptoms can fluctuate even during a cardiac event, so temporary relief should not provide false reassurance when warning signs or cardiovascular risk factors are present.

“The threshold for seeking medical evaluation should be even lower in people with diabetes, high blood pressure, obesity, smoking history, established heart disease or a strong family history of premature heart disease,” said Dr Sunil.