Is heartburn the same as a heart attack?

No, but they can feel similar, and reflux is a common reason people delay getting help for a heart attack. Pain that comes with sweating, breathlessness, nausea or pain spreading into the arm, neck or jaw should be treated as cardiac until proven otherwise.

Why does my heartburn come back when I stop the tablets?

Acid-suppressing medicines control symptoms rather than cure the underlying valve problem, so symptoms often return when they stop. That is expected, not a sign the medicine failed — but persistent dependence on them is a reason to be properly assessed.

Health library

Everyday symptoms

Heartburn and reflux: what to try, and when to worry

Burning behind the breastbone is usually reflux and usually manageable — but a few symptoms mean you should stop self-treating and get checked.

What reflux actually is

The muscle at the bottom of the gullet is meant to stay shut between swallows. When it relaxes at the wrong time, stomach acid moves up into the gullet, which has no protective lining. That is the burn.

It is worse lying down and worse after a large meal, which is why the classic pattern is heartburn in bed a couple of hours after supper.

Changes that work before medicine does

Eat your last meal three hours before lying down. This single change fixes night-time reflux for a lot of people.
Raise the head of the bed by 10–15 cm — under the bed legs, not with extra pillows, which bend you at the waist and make it worse.
Smaller meals rather than fewer, larger ones.
Cut back on the usual triggers if they affect you: alcohol, very fatty or spicy food, chocolate, peppermint, coffee and fizzy drinks.
Stop smoking, and lose weight around the middle if that applies. Both directly affect how well that valve closes.

The medicines, from mildest up

Antacids neutralise acid that is already there. They work within minutes and wear off within hours, which makes them right for occasional heartburn and wrong for daily symptoms.

Acid-suppressing medicines such as omeprazole (Losec) and pantoprazole reduce how much acid the stomach makes in the first place. They take a day or two to work properly and are taken before food, usually in the morning. They suit persistent reflux rather than a one-off.

Symptoms that need a doctor, not a pharmacy

Common questions

Is heartburn the same as a heart attack?: No, but they can feel similar, and reflux is a common reason people delay getting help for a heart attack. Pain that comes with sweating, breathlessness, nausea or pain spreading into the arm, neck or jaw should be treated as cardiac until proven otherwise.
Why does my heartburn come back when I stop the tablets?: Acid-suppressing medicines control symptoms rather than cure the underlying valve problem, so symptoms often return when they stop. That is expected, not a sign the medicine failed — but persistent dependence on them is a reason to be properly assessed.

Sources

Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa

Last reviewed 4 August 2026.