Heartburn and cardiac chest pain can feel unsettlingly similar, and that overlap is exactly why chest pain should never be self-diagnosed as reflux, especially the first time it happens. That said, there are patterns that lean one way or the other. Heartburn typically: follows a meal, worsens when lying down or bending over, improves with antacids within minutes, and comes with a sour taste or regurgitation. Cardiac pain more often: comes with exertion, radiates to the arm, jaw, or back, comes with shortness of breath, sweating, or dizziness, and doesn't ease with antacids. These patterns are not a diagnostic test — they're a reason to take new or severe chest pain seriously. Any chest pain that is sudden, severe, accompanied by shortness of breath, or unlike previous heartburn warrants emergency care, not a wait-and-see approach.
