ZocdocAnswersDoes this sound like a heart attack or GERD?

Question

Does this sound like a heart attack or GERD?

Last night, I had a really bad pain between my shoulder blades specifically on the left side. It hurt to take deep breaths.It would feel a bit better when I laid down flat or on my side. I would burp or fart when I sat up as well. I could point to the exact spot on my back where the pain was coming from. My pulse was normal but it really hurt to sit up or bend over.This lasted about 6 hours or so before I fell asleep and I woke up this morning and felt fine and even worked out with no troubles. This has happened to me before and I went to the ER in the past for it and was diagnosed with IBS/Non-ulcer dyspepsia. I noticed that it happens usually when I eat nachos, red meat or something spicy as well. Is this just a another bad attack from my IBS?

Answer

It is difficult to determine the cause of your symptoms without an in-person evaluation, and I urge you to consult your physician to help rule out a dangerous cause of your symptoms. A possible cause of chest pain that radiates between your shoulder blades is aortic dissection, which is a partial tear of the primary blood vessel that exits your heart. This is life threatening and usually does not resolve on its own. Pericarditis, or inflammation within the fibrous sac around your heart, can also cause chest pain that varies with position. Although your description of pain is somewhat atypical for coronary ischemia, or impaired blood flow to your heart muscle, it is not possible to rule this out without an in-person evaluation and without knowing more about your medical history. Therefore, I recommend you see your physician for a full evaluation. As you mentioned, several gastrointestinal issues can also cause chest or back pain. Gastroesophageal reflux disease, or GERD, occurs with acidic stomach contents are able to reach the esophagus, causing inflammation. This can also trigger spasm of your esophageal sphincter muscle, which can cause severe pain. As you mentioned, certain foods can trigger such symptoms. Treatment typically consists of weight loss and dietary changes along with medical therapy, such as Omeprazole. Your symptoms are not consistent with irritable bowel syndrome (IBS). However, I encourage you to consult your doctor about these possibilities.

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