Heartburn after birth turned out to be a sign of a heart attack in a patient

Under the guise of diseases of the gastrointestinal tract, often hidden diseases of completely different organs and systems. Including those requiring urgent care. And not only the health but also the life of the patient sometimes depends on how the doctor can make a differential diagnosis. For example, heartburn is a feeling of discomfort or burning in the upper abdomen and behind the chest, along the esophagus. Heartburn is caused by the acidic contents of the stomach entering the esophagus. However, the problem is that burning behind the sternum can also occur with coronary heart disease.

Dinara Renatovna Galimova, gastroenterologist at the Open Clinic at Prospekt Mira, shares with readers recent examples from her practice.

– A 45-year-old man came to see me with complaints of heartburn, which bothered him for several hours. He associated the appearance of heartburn with a rich dinner with friends in honor of the birthday of one of them. According to him, he had heartburn in the past, but his episodes were short-lived. He did not go to the doctor for that, he took soda on his own in order, in his words, to “extinguish the acid in the stomach”.

That day, he also took a soft drink, but the heartburn did not disappear – instead, it became painful and was accompanied by the appearance of pressures and pressures, burning sensations behind the chest. Therefore, the man decided to apply for an appointment with a gastroenterologist.

After talking to the patient, I urgently sent him for a cardiac electrocardiogram, the results of which revealed a myocardial infarction. The man was rushed to hospital.

The burning sensation behind the sternum, which he took for heartburn, was not caused by acid reflux in the stomach, but by a violation of blood circulation in the heart.

Well, how to clinically distinguish a disease of the gastrointestinal tract from a cardiovascular pathology. Yes, heartburn is the main symptom of gastroesophageal reflux disease (GERD) and it can be very difficult to distinguish the clinical manifestations of GERD from coronary heart disease (CF), especially because the diseases can be interrelated.

But there are still a number of features.

First, if the burning behind the sternum is caused by the reflux of the contents into the esophagus, taking any antacid (in this case, soda) will reduce it. With coronary heart disease, burning will be reduced only under the influence of nitrates.

Second, BPD symptoms are more likely to occur when lying down or crouching, especially when a person has eaten. And with coronary heart disease – after physical exercise or emotional stress.

In addition, with IHD, the burn can spread to the left arm, shoulder, under the shoulder and lower jaw.

The patient I am talking about had a pressing burning sensation behind the sternum, which did not diminish, but only became more painful. And in such cases, the patient should always be referred to the cardiogram, because under the guise of GOP can hide a heart attack.

If heartburn and burning behind the sternum occur more than twice a week, especially if the episodes increase in intensity, this is an opportunity to consult a doctor.

As for GERD, today it is a very “popular” disease, equally common in men and women. According to statistics, 20 to 40% of the earth’s inhabitants suffer. Unfortunately, we find more and more of this pathology in children.

In addition to heartburn, GERD can be indicated by chest pain (especially when eating rough food), cough, hoarseness, dry throat, digestive disorders (pain, bloating, nausea, vomiting), acute sore throat, stomach discomfort, pressure which occurs half an hour after a meal and is aggravated by the use of spicy, fatty, fried, alcoholic, acidic fruit juices.

The disease is not harmless at all: it can lead to the development of gastritis, ulcers, and even esophageal cancer. GERD develops due to the long-term entry of the acidic contents of the stomach into the esophagus (scientifically called reflux). In other words, the half-digested food ends up where it normally should not be at all. And the esophageal sphincter is called in to prevent her from going there. However, sometimes this protective barrier refuses to work. This is facilitated by bad habits (strong friendship with the green snake and nicotine), obesity, consumption of fatty foods. Reflux often develops in coffee lovers, as well as due to taking a number of medications (for example, antidepressants or anticonvulsants). Another reason is an unbalanced diet. In addition, people who are often in a state of nervous tension are susceptible to GERD. It is impossible not to take into account the harmful effect of pathogens on the work of the gastrointestinal tract, and in particular – Helicobacter pylori.

GERD is often a symptom of gastritis or stomach ulcers. In the chronic stage of the disease, erosions (tiny cracks), narrowing of the esophagus, and even esophageal cancer can develop.

In any case, if you have annoying symptoms, consult a doctor! Only he can determine their cause and help you.

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