You finish a heavy meal, feel a burning in your chest, take an antacid and carry on. Most of the time it is nothing serious. But Dr. A. Sreenivas Kumar sees many patients who dismissed heart pain as gas until it became an emergency.
Even cardiologists sometimes need tests to be sure. Still, there are clear patterns everyone should know.
Quick takeaways
- Discomfort that comes on with walking or work and settles with rest needs a heart check.
- Pain after meals can also be heart-related.
- Pain that wakes you from sleep should never be ignored.
- Women may have no chest pain at all.
When to get emergency help
Call an ambulance (108 in India) or go to the nearest emergency department straight away if you have severe chest pain or pressure, pain with sweating, breathlessness, fainting, or sudden severe tearing pain in the back. Do not drive yourself, and do not wait to see whether an antacid helps.
Why the heart hurts when you walk
At rest, your heart beats about 60 to 70 times a minute, and even a narrowed artery may supply enough blood. When you walk or work, the heart needs more oxygen. A blocked artery cannot deliver it, and discomfort follows. Doctors call this angina.
| More likely to be the heart | Less likely to be the heart |
|---|---|
| Comes on with walking or effort | Stays the same whether you move or rest |
| Eases when you rest | Continues all day |
| Spread across the chest | A pricking pain at one small spot |
| Travels to the arm or jaw | Does not spread |
| You are older, diabetic or a smoker | You are young with no risk factors |
These are general patterns, not a way to diagnose yourself. Age and risk matter too: the same symptom means something different in a healthy 30-year-old than in a 55-year-old smoker with diabetes.
What blockage does at each stage
| Blockage | What you may notice |
|---|---|
| Around 50% | Usually no major symptoms |
| Around 70% | Symptoms on walking or exertion |
| Over 90% | Pain may occur even when sitting |
| 100% | Heart attack: severe pain, sweating, collapse or sudden death |
The after-meal trap
After eating, more blood goes to the stomach and less may reach the heart. Some people get pain after food, known as post-prandial angina. Many of them assume it is gas and lose valuable time.
Symptoms in women can look different
Women often do not have classic chest discomfort. They may instead feel unusual tiredness, weakness, palpitations, breathlessness on mild effort, or dizziness.
Three red flags
- Pain that wakes you up. Get checked at a hospital. Doctors should observe you and run tests before ruling out a heart problem.
- Sudden severe stabbing pain in the back. This can be aortic dissection, a tear in the body’s main artery, and is an emergency.
- Thinking “I am fit, this cannot happen to me.” Risk is higher with risk factors, but nobody is fully immune.
Frequently asked questions
If an antacid relieves the pain, is it definitely gas?
No. Do not rely on this. If you have any doubt, see a doctor.
How do doctors confirm it?
The history you give is the most valuable clue, along with ECGs repeated over time, blood tests such as troponin, and a heart scan.
Why is the first hour so dangerous?
A sudden blockage can cause a dangerous heart rhythm called ventricular fibrillation, which is why every minute counts.
Have a question about your heart?
Dr. A. Sreenivas Kumar is a Senior Consultant Cardiologist and Director of Cardiology and Clinical Research at Apollo Hospitals, Hyderabad. If you have symptoms or risk factors, book a consultation rather than waiting for them to get worse.
This article is for general education and is adapted from Dr. Kumar’s public talks on SumanTV. It does not replace medical advice for your own condition. Please do not start or stop any medicine without speaking to your doctor.