Can Heart Disease Cause Stomach Pain? Dr. Hossam Mowafi Explains

Heart disease, specifically an inferior wall myocardial infarction, can cause pain in the upper stomach area, according to Professor Hossam Mowafi. This referred pain occurs when the brain misinterprets signals from the lower part of the heart as originating from the gastric region, which can lead patients to mistake a cardiac event for indigestion or stomach distress, as reported by Al-Consulto.

Professor Mowafi, a professor of medicine, explains that the lower wall of the heart sits near the diaphragm. When this area of the heart suffers from ischemia or an infarction, the resulting pain often radiates to the epigastrium, the upper central region of the abdomen.

This phenomenon is known in medical literature as referred pain. It happens because the nerves that supply the heart and the nerves that supply the stomach enter the spinal cord at similar levels, causing the brain to confuse the source of the pain signal.

The confusion between cardiac and gastric pain often delays emergency treatment. Patients may take antacids or stomach medications instead of seeking immediate cardiac care, which increases the risk of permanent heart muscle damage.

Why does heart pain feel like stomach pain?

The proximity of the heart’s inferior wall to the diaphragm and the stomach is the primary anatomical reason for this overlap. According to the American Heart Association, the nerves serving these organs often share common pathways to the brain.

When the lower part of the heart lacks oxygen, the pain signals travel along these shared pathways. The brain, which is more accustomed to receiving pain signals from the digestive system in that specific region, interprets the sensation as stomach pain or severe heartburn.

This is distinct from the classic “crushing” chest pain associated with the anterior wall of the heart. While anterior infarctions typically cause pressure in the center of the chest, inferior infarctions are more likely to present as abdominal discomfort.

Who is most likely to experience these atypical symptoms?

Not all patients experience the traditional “Hollywood” heart attack symptoms. Certain demographics are more prone to atypical presentations, including stomach pain and nausea, according to data from the Mayo Clinic.

• Women: Women are more likely than men to report shortness of breath, nausea, and upper abdominal pain rather than intense chest pressure.
• People with Diabetes: Diabetic neuropathy can blunt the sensation of pain, meaning a heart attack may manifest as vague stomach discomfort or fatigue rather than acute pain.
• Elderly Patients: Older adults often present with “silent” or atypical infarctions, where confusion or gastric distress are the primary symptoms.

These variations make the diagnostic process more complex, as clinicians must rule out gastrointestinal issues like gastritis or gallstones before confirming a cardiac cause.

How do atypical cardiac symptoms differ from gastric issues?

Distinguishing between a heart attack and a stomach ailment depends on the accompanying symptoms and the trigger of the pain. According to medical reporting from Al-Consulto, cardiac-related stomach pain often appears suddenly and is not relieved by digestive medications.

Typical gastric pain is often linked to food intake, specific triggers, or the use of nonsteroidal anti-inflammatory drugs. In contrast, referred cardiac pain is frequently accompanied by other systemic signs of distress.

These signs often include:

• Cold sweats or sudden clamminess.
• Shortness of breath, even while resting.
• Pain radiating to the jaw, neck, or left arm.
• A sudden sense of nausea or lightheadedness.

The presence of these systemic symptoms suggests that the abdominal pain is a secondary manifestation of a cardiovascular emergency rather than a primary digestive problem.

Medical professionals use electrocardiograms (ECG) and troponin blood tests to differentiate these conditions. An ECG can quickly identify if the “stomach pain” is actually an inferior wall myocardial infarction, allowing for immediate intervention to open blocked arteries.