Chest burning can be a worrying symptom, especially when it happens without any physical exertion. Many people immediately wonder if it’s a sign of heart trouble or something like acid reflux. Understanding the possible causes and knowing when to seek medical attention can help you feel more in control of your health. In this article, we’ll explore why chest burning occurs, how to distinguish between gastrointestinal and cardiac causes, the tests doctors may recommend, and what you should track to prepare for a medical appointment.
No two cases are exactly alike, and symptoms can overlap. If you’re experiencing chest burning, especially if it is new or severe, it’s always a good idea to speak with a healthcare professional for a personalised assessment.
Common causes of chest burning
Chest burning is a sensation that can have several different origins. The most common causes include:
- Gastroesophageal reflux disease (GERD): Stomach acid travels back into the oesophagus, causing a burning feeling known as heartburn.
- Peptic ulcers: Sores in the stomach or upper intestine can cause burning pain that sometimes radiates to the chest.
- Muscle strain: Overuse or minor injuries to the chest muscles can lead to a burning sensation, often worsened by movement or touch.
- Anxiety and panic attacks: These can cause a feeling of chest burning or tightness, sometimes accompanied by palpitations or shortness of breath.
- Cardiac conditions: Reduced blood flow to the heart muscle (angina) or a heart attack (myocardial infarction) can sometimes present as burning rather than classic pressure pain.
- Respiratory causes: Infections of the lungs or airways, such as bronchitis or pneumonia, may also produce a burning feeling in the chest.
Not every episode of chest burning is a sign of a serious problem, but some require urgent attention. The location, duration, and associated symptoms play a key role in determining the underlying cause.
GERD vs cardiac symptoms
The challenge for many patients and healthcare providers is distinguishing between chest burning caused by acid reflux and that caused by heart issues. Here’s how these two conditions often compare:
Features of GERD (Acid Reflux)
- Burning sensation behind the breastbone, often after eating or when lying down
- May be accompanied by a sour or bitter taste in the mouth
- Symptoms can improve with antacids
- Often related to certain foods (spicy, fatty, or acidic)
- Rarely causes shortness of breath or sweating
Features of Cardiac (Heart) Causes
- Burning or pressure-like pain in the centre or left side of the chest
- May radiate to the arm, neck, jaw, or back
- Can occur at rest or with mild activity
- Frequently associated with shortness of breath, sweating, nausea, or lightheadedness
- Not relieved by antacids
It’s important to note that these symptoms can overlap. For example, some people with heart problems may only experience burning, without the classic “crushing” pain. Women and people with diabetes may have atypical presentations. When in doubt, err on the side of caution and seek medical advice.
Which exams doctors may order
If you visit a doctor with chest burning, they will begin with a detailed history and physical examination. Depending on your risk factors and the characteristics of your symptoms, several tests may be considered:
- Electrocardiogram (ECG/EKG): Measures the electrical activity of your heart to look for signs of a heart attack or reduced blood flow.
- Blood tests: Can detect markers of heart damage (such as troponin) or signs of infection.
- Chest X-ray: Useful for identifying lung problems or other causes of chest discomfort.
- Exercise stress test: Evaluates how your heart performs under stress, helping to uncover problems with blood flow to the heart muscle.
- Echocardiogram: An ultrasound of the heart to check for structural or functional abnormalities.
- Upper endoscopy (gastroscopy): Used to visualise the oesophagus and stomach directly, which can help diagnose GERD, ulcers, or other digestive issues.
- pH monitoring: Measures acid levels in the oesophagus over 24 hours to confirm acid reflux.
The choice of tests depends on your age, medical history, and specific symptoms. A younger person with clear reflux symptoms and no risk factors may need fewer tests than someone with heart disease risk factors.
Warning signs of emergencies
While many causes of chest burning are not dangerous, some require urgent medical attention. Recognising these warning signs can be lifesaving:
- Chest pain that is severe, sudden, or lasts more than a few minutes
- Pain radiating to the arm, neck, jaw, or back
- Shortness of breath, especially at rest
- Cold sweats, nausea, or vomiting
- Lightheadedness or fainting
- Chest burning accompanied by palpitations or irregular heartbeat
- Difficulty speaking, weakness, or numbness on one side of the body
If you or someone you know experiences these symptoms, call emergency services immediately. Quick action can make a significant difference, particularly if a heart attack or stroke is suspected.
What to track before appointments
Preparing for your appointment can help your doctor make an accurate diagnosis. Keeping a symptom diary is especially useful. Here’s what you should track:
- When the chest burning occurs: Note the time of day and any possible triggers (e.g., after meals, during stress, at rest).
- Duration and intensity: How long does it last? Is it mild, moderate, or severe?
- Associated symptoms: Record other symptoms such as shortness of breath, nausea, palpitations, or sweating.
- Relieving or aggravating factors: Does anything make it better or worse (such as eating, lying down, exercise, or medications)?
- Medical history: Note any personal or family history of heart disease, digestive problems, or other relevant conditions.
- Medications and supplements: Bring a list of everything you’re taking, including over-the-counter remedies.
Having this information at hand can make your appointment more productive and help your doctor decide which tests or treatments are most appropriate.
If you notice that chest burning happens frequently, learning about when to seek further medical evaluation for persistent heartburn can be helpful; see our guide on when frequent heartburn needs to be checked by a doctor for more details.
In summary, chest burning without exercise is a common but sometimes confusing symptom. It can be caused by acid reflux, heart problems, or even anxiety. Paying attention to warning signs and preparing for your appointment can help ensure you get the right care. If you are ever unsure or worried about your symptoms, do not hesitate to contact a healthcare professional for advice.
