Doctors Note Logo

Published on: 2/4/2026

Atypical Chest Pain: Why Seniors Often Mistake Heart Attacks for Acid Reflux

Seniors often mistake chest discomfort for acid reflux because heart attacks in older adults can feel like mild pressure or burning and may come with shortness of breath, nausea, or unusual fatigue, with age-related pain blunting, diabetes, and common digestive issues adding to the confusion. There are several factors to consider; see below to understand key differences between reflux and heart-related symptoms, the red flags that need urgent care, why early treatment matters, and practical next steps for when to seek emergency help and how to talk with your doctor.

answer background

Explanation

Atypical Chest Pain: Why Seniors Often Mistake Heart Attacks for Acid Reflux

Chest discomfort is frightening, but it is also confusing—especially for older adults. Many seniors assume that burning, pressure, or discomfort in the chest is Acid Reflux, not a heart problem. In reality, heart attacks in older adults often feel very different from the dramatic chest-clutching scenes shown on television. Understanding why this confusion happens can help people recognize when symptoms deserve urgent medical attention.

This article explains why seniors often mistake heart attacks for Acid Reflux, what makes chest pain “atypical,” and how to tell when symptoms should not be ignored.


What Is Acid Reflux?

Acid Reflux occurs when stomach acid flows backward into the esophagus, the tube that connects your mouth to your stomach. This backward flow can irritate the lining of the esophagus and cause uncomfortable symptoms.

Common symptoms of Acid Reflux include:

  • Burning pain or pressure in the chest (heartburn)
  • A sour or bitter taste in the mouth
  • Burping or bloating
  • Symptoms that worsen after eating or lying down
  • Relief from antacids

Because these symptoms are so common—especially in older adults—it is easy to assume that chest discomfort is digestive rather than heart-related.


What Is Atypical Chest Pain?

“Atypical chest pain” means chest discomfort that does not follow the classic pattern of a heart attack. In seniors, heart attacks may not cause sudden, crushing chest pain. Instead, symptoms can be subtle, vague, or mistaken for Acid Reflux or indigestion.

Atypical symptoms may include:

  • Mild chest pressure rather than sharp pain
  • Burning that feels like heartburn
  • Pain that comes and goes
  • Discomfort that spreads to the neck, jaw, back, or upper stomach
  • Shortness of breath without chest pain
  • Nausea or vomiting
  • Fatigue or weakness

Because these symptoms overlap so much with Acid Reflux, many seniors delay seeking care.


Why Seniors Are More Likely to Confuse Heart Attacks With Acid Reflux

1. Age-Related Changes in Pain Perception

As people age, nerve sensitivity can decrease. This means a heart attack may not produce intense pain. Instead, it may feel like pressure, burning, or discomfort—similar to Acid Reflux.

Some seniors may describe their symptoms as:

  • “Indigestion”
  • “Gas”
  • “A heavy feeling”
  • “Something not sitting right”

These descriptions often lead people to try antacids instead of calling for help.


2. Higher Rates of Digestive Problems

Older adults are more likely to experience Acid Reflux, hiatal hernias, and other digestive conditions. When chest discomfort happens, they naturally assume it is another reflux episode—especially if they have had heartburn for years.

If antacids partially relieve symptoms, this can further delay medical evaluation, even though heart-related pain can sometimes ease temporarily.


3. Chronic Health Conditions Can Mask Symptoms

Seniors often live with conditions such as:

  • Diabetes
  • High blood pressure
  • Kidney disease
  • Nerve damage (neuropathy)

Diabetes, in particular, can blunt pain signals from the heart. This increases the risk of a “silent” or atypical heart attack that feels more like Acid Reflux than a cardiac emergency.


4. Symptoms Do Not Match Expectations

Many people believe heart attacks always cause sudden, severe chest pain. When symptoms are mild or gradual, they may not seem serious enough to be heart-related.

Instead of thinking “heart attack,” seniors may think:

  • “I ate too much.”
  • “This is just my reflux acting up.”
  • “I don’t want to overreact.”

Unfortunately, waiting can allow heart damage to worsen.


How to Tell the Difference: Acid Reflux vs. Heart-Related Chest Pain

While no rule is perfect, certain patterns can help raise concern.

Symptoms More Common With Acid Reflux

  • Burning pain behind the breastbone
  • Symptoms that start after meals
  • Pain that improves with antacids
  • Discomfort when lying flat
  • Sour taste in the mouth

Symptoms That May Signal a Heart Problem

  • Chest pressure or tightness rather than burning
  • Pain spreading to the arm, jaw, neck, or back
  • Shortness of breath
  • Sweating without a clear reason
  • Dizziness or lightheadedness
  • Nausea without stomach upset
  • Unusual fatigue

If chest discomfort feels different from your usual Acid Reflux, that difference matters.


Why Delaying Care Is Risky

Heart attacks are time-sensitive. The longer the heart muscle is deprived of oxygen, the greater the risk of permanent damage. Seniors who mistake heart symptoms for Acid Reflux may wait hours—or even days—before seeking help.

Medical experts consistently stress that early treatment:

  • Reduces heart damage
  • Improves survival
  • Lowers the risk of long-term complications

It is better to be checked and reassured than to miss a serious condition.


When to Seek Immediate Medical Help

Do not ignore chest discomfort if it:

  • Is new, severe, or unusual
  • Does not improve quickly with antacids
  • Comes with shortness of breath, sweating, or weakness
  • Wakes you from sleep
  • Feels different from your typical Acid Reflux

If symptoms could be life-threatening, seek emergency care right away and speak to a doctor as soon as possible.


Using Symptom Tools Wisely

For non-emergency concerns, some people find it helpful to get guidance before deciding what to do next. You may consider doing a free, online symptom check for Medically approved LLM Symptom Checker Chat Bot to better understand possible causes of your symptoms.

Symptom checkers can:

  • Help you organize what you are feeling
  • Suggest when medical care may be needed
  • Support better conversations with your doctor

They are not a replacement for professional medical care, especially when symptoms could be serious.


Talking With Your Doctor About Chest Symptoms

Even if chest discomfort turns out to be Acid Reflux, it is still worth discussing with a healthcare professional. Ongoing reflux can damage the esophagus and affect quality of life.

When you speak to a doctor, be prepared to describe:

  • When the symptoms started
  • What they feel like
  • What makes them better or worse
  • How often they occur
  • Any history of heart disease or risk factors

Clear communication helps your doctor determine whether symptoms are digestive, cardiac, or something else.


The Bottom Line

Seniors often mistake heart attacks for Acid Reflux because symptoms can overlap, pain may be milder, and digestive issues are common with age. While many cases of chest discomfort are not heart-related, some are—and delaying care can be dangerous.

Listen to your body. If something feels new, unusual, or more intense than your typical Acid Reflux, do not dismiss it. Use tools wisely, but always speak to a doctor about symptoms that could be serious or life-threatening. Early attention can make all the difference.

(References)

  • * Lopez-Sendon J, Recio-Mayoral A. Acute coronary syndromes in the elderly: a different disease? Rev Esp Cardiol (Engl Ed). 2011 May;64(5):417-25. doi: 10.1016/j.rec.2010.12.016. Epub 2011 Apr 19. PMID: 21501723.

  • * Qureshi WT, Jameel M, Khan S, Zafar M, Memon F, Qazi A, Iqbal A. Atypical Presentations of Myocardial Infarction: Case Report and Literature Review. Cureus. 2021 Mar 18;13(3):e13994. doi: 10.7759/cureus.13994. PMID: 33880313; PMCID: PMC8052134.

  • * Zair M, Roldan P, De la Cruz A, Moreno R. Acute coronary syndrome in elderly patients: unique challenges and considerations. Curr Cardiol Rep. 2013 Aug;15(8):389. doi: 10.1007/s11886-013-0389-9. PMID: 23801267.

  • * Canto JG, Canto JA, Goldberg RJ, Bittner V, Osayimwen E, Lee KL, Rogers WJ. Atypical symptoms and delayed presentation among older adults with acute myocardial infarction. J Am Geriatr Soc. 2008 Feb;56(2):338-41. doi: 10.1111/j.1532-5415.2007.01570.x. PMID: 18275468.

  • * Kim J, Choi MG, Kim SE, Kim TO, Kim SJ, Chae DW, Kweon HK, Kang YS, Cho SH, Choi YK, Kim HI, Kim GH. Is There a Specific Symptom Complex Suggestive of Myocardial Infarction in Patients with GERD? Am J Med. 2008 Aug;121(8):699-705. doi: 10.1016/j.amjmed.2008.03.031. PMID: 18692695.

Thinking about asking ChatGPT?Ask me instead

Tell your friends about us.

We would love to help them too.

smily Shiba-inu looking

For First Time Users

What is Ubie’s Doctor’s Note?

We provide a database of explanations from real doctors on a range of medical topics. Get started by exploring our library of questions and topics you want to learn more about.

Was this page helpful?

Purpose and positioning of servicesUbie Doctor's Note is a service for informational purposes. The provision of information by physicians, medical professionals, etc. is not a medical treatment. If medical treatment is required, please consult your doctor or medical institution. We strive to provide reliable and accurate information, but we do not guarantee the completeness of the content. If you find any errors in the information, please contact us.