Wednesday, August 7, 2013

Heart Burn or Heart Attack?

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“I feel my temperature rising
Help me, I'm flaming
I must be a hundred and nine
Burning, burning, burning
And nothing can cool me

I just might turn into smoke” - Elvis Presley, Burning Love

If you find yourself channeling Elvis Presley and you are feeling your temperature rising, and you are flaming, burning and nothing can cool you, and its not because of a significant other, you may be feeling heartburn.  Most people find heartburn to be a common annoyance, not a serious health issue. But increasingly heartburn can be an indicator of a serious health issue such as a heart attack or even cancer.  So how do you tell the difference between cardiac problems, cancer problems or just that bowl of chili you ate?

PinnacleHealth Medical Group physician Jessica Rubertone, MD explains what heartburn is.  “Gastroesophageal reflux disease, otherwise known as "GERD," is a very common problem in the Western world. Heartburn happens when stomach acid travels up the esophagus and causes irritation. Heartburn is a very common symptom of GERD, and can feel like a burning in the chest or throat. A sour or bitter taste, and sometimes a cough, may accompany the burning feeling. Sometimes it can even feel like chest pressure, or when it is severe, can feel like food or pills are getting stuck in the throat when swallowing.”

According to Dr. Rubertone, there are many things you can do to help avoid heartburn and GERD. Two of the most important things are to lose weight and quite smoking. She says, “ It is known that heartburn is more common in those that are overweight and also those that smoke. Avoidance of caffeine, spicy or greasy foods, and alcohol are also important, as these will contribute to heartburn.”  And, she adds, don’t stress as anxiety and stress can contribute to heartburn. Dr. Rubertone recommends treating yourself on a regular basis to yoga, prayer, exercise, or whatever you like to do to relax. If you have tried these ideas, and still suffer from heartburn, a sour taste, a feeling that food is getting caught in the throat, or a persistent cough, be sure to speak with your doctor as this could indicate a more serious condition like a heart problem or even cancer.

PinnacleHealth general surgeon Joseph Esposito, MD, explains the tie between cancer and heartburn(GERD). "Heartburn caused by acid reflux can over time change the cells in the lining of the esophagus. These changes, commonly referred to as Barrett's Esophagus, increase your risk for esophageal cancer which is especially lethal." For patients with frequent heartburn an upper endoscopy procedure can help identify the cause and determine if the patient has an increased risk for cancer. We can then determine in the individual patient the best alternatives. Minimally invasive or robotic anti-reflux surgery to cure reflux as well as radiofrequency ablation (RFA) to cure the existing Barrett's are options.  Surgery makes a new valve to prevent the cause and RFA heats the already present abnormal cells until they are gone. Fortunately, we now have multiple options.

Sometime heartburn is actually a symptom of a cardiac event, like a heart attack. “Unfortunately, women sometimes confuse the symptoms of a heart attack and heartburn,” says Mehreen Qureshi, MD, cardiologist with PinnacleHealth Cardiovascular Institute.

“Women are more likely than men to experience symptoms other than chest pain during a heart attack,” says Dr. Qureshi. Women’s symptoms often are more vague and are overlooked. Heart attack symptoms can include:

•    Pressure or burning feeling in the chest
•    Unexplained, extreme fatigue
•    Pain or discomfort that radiates to the arm, jaw, neck and/or back
•    Nausea, dizziness and/or vomiting
•    Breaking out into a cold sweat
•    Severe shortness of breath

Since time is muscle in a heart attack, call 911 and ask for PinnacleHealth’s Harrisburg Hospital if you think you may be having a heart attack.

If you have risk factors such as high blood pressure, diabetes, a smoking history, high cholesterol or a strong family history of heart disease and are concerned that you may be experiencing some of the above symptoms periodically, you should call to schedule an appointment to discuss your concerns with a cardiologist.

Sometimes though, that burning feeling is just a result of large bowl of chili, or similarly spicy food.  So how can you tell when there is a problem?  If you frequently experience heartburn you should consult your primary care physician who can evaluate your condition and risk factors and send you to an experience specialist if need be.  With the right team of providers working with you, you can look forward to getting warm and fuzzy feelings from loved ones, not heartburn.