Heart attacks are not always a dramatic scene where the person collapses with severe, crushing chest pain. Instead, you may have vague stomach pain, indigestion, or heartburn. Although stomach pain can be due to many other conditions, grappling with whether your stomach pain is heartburn or heart attack takes up valuable time. Play it safe and seek help if you have any doubt. How are stomach pain and heart attack connected? A heart attack is usually caused by a blood clot that forms in a coronary artery. This blocks blood flow to your heart and often causes a cramping or squeezing type of pain in the center of your chest. Sometimes this pain can spread to the upper stomach area (upper abdomen). Although the pain is really coming from your heart, you may only feel it in your stomach area and not in your chest at all. The pain, which may worsen with even minor activity, may also spread up to your left shoulder and arm. This is more common in women than in men. You may also feel queasy or sick to your stomach and vomit. What else could cause stomach pain? It’s easy to mistake the stomach pain of a heart attack for other problems, especially when it occurs without chest pain. The following diseases and conditions are known to cause stomach pain that feels like that of a heart attack: Acid reflux or gastroesophageal reflux disease (GERD), a backup of stomach contents and acids into the esophagus Heartburn, a burning feeling in your stomach or chest behind the breastbone due to a problem with food digestion Indigestion in your stomach area caused by a digestive problem. You may feel bloated and have visible swelling. Peptic ulcer, a breakdown in the lining of the stomach or upper part of the small intestine Gastritis, an irritation of your stomach lining Pancreatitis, an inflammation of your pancreas Gallbladder disease, including cholecystitis (inflammation of the gallbladder) or choledocholithiasis (passing gallstones) Hepatitis, an infection or inflammation of your liver When should I call my doctor or 911? Contact your doctor if you have ongoing mild to moderate stomach pain. Just before or during a heart attack, some people are known to feel vague restlessness or nervousness, or a deep sense of dread or doom. Call 911 if you have sudden or severe stomach pain with these feelings, or any of the following symptoms: Breaking out in a cold sweat Feeling light-headed, dizzy, or passing out Fatigue or weakness Nausea and vomiting Pain in your shoulder, neck, arms, back, teeth or jaw Pain, pressure, squeezing or any type of uncomfortable feeling in your chest Problems breathing, such as panting or feeling like you can’t catch your breath Sweaty, pale, cold or clammy skin People with stomach pain caused by a heart attack often do not call 911 because they believe their pain is caused by a minor problem. You may also wait to see if it goes away by itself. However, without rapid treatment, a heart attack can quickly cause permanent heart damage and death. Don’t hesitate. Every second counts in a heart attack, and medical personnel would rather you call 911 for a stomach problem than ignore a possible heart attack. Do not drive to the hospital or let someone else drive you. Calling 911 is the fastest way to treat a heart attack because emergency medics will begin treatment as soon as they arrive. Your medics will notify the hospital right away so the ER staff is ready to continue treatment when you arrive. They will treat you as if you are having a heart attack until your test results indicate otherwise. Don’t assume your unexplained stomach pain is a harmless problem. Get the treatment you need quickly to live a long and healthy life.