Acid reflux, which can cause burping, has been observed in people with coronary artery disease.
Working in the IT city of Bengaluru, a busy professional can be expected to have irregular diet, sleep and exercise patterns and stress. All of these lead to routine gastrointestinal discomfort like burping and belching. But some of these symptoms could also indicate a heart condition. Like this 32-year-old software professional who showed up at the OPD complaining of his recent bout of burping that would be embarrassing socially. Strangely, he said, he would not burp after a meal. But he would do so soon after a walk or whenever he climbed stairs. Was this a red flag?
His physical test results were normal, including pulse and blood pressure. His body mass index (BMI) was 25. His complete blood count, electrolytes, creatinine, kidney and liver function tests, lipids and glucose were normal. A routine resting electrocardiogram was also normal. That’s when we did a stress test electrocardiogram, which shows how your heart works when it needs more oxygen, revealing blockages or rhythm problems not seen at rest. That’s when we found him strongly positive for angina pectoris, a chest pain or discomfort indicating that a part of your heart doesn’t get enough blood and oxygen because of blockage.
Coronary angiography showed 50% narrowing at the left anterior descending (LAD) and over 95% blockage of the right coronary artery (RCA) and its branch, the posterior descending artery (PDA). Basically, he had severe blockages. He needed a bypass surgery, a surgical procedure to restore blood flow to the heart muscle by creating a new pathway around blocked arteries. Subsequently, he was put on statins and aspirin medication. Since then, he has not reported any cardiac stress.
Why the kind of burping is important
TL;DR: Our patient did not present with typical symptoms of blockage or heart attack, like chest pain, breathlessness or sweating, symptoms which are easier to identify.
Our patient did not present with typical symptoms of blockage or heart attack, like chest pain, breathlessness or sweating, symptoms which are easier to identify. Belching, burping, chills and fatigue do not sound like symptoms of heart attack to most patients. Even doctors overlook it at times. This delays treatment and leads to damage to the heart muscle and even death.
Most of the time, burping is related to gastroenterological reasons, in which case it is chronic. But it can signal heart problems when you get it after fast physical activity, say brisk walking or taking the stairs, when it happens with some chest discomfort or pain, when there is a sudden onset of bouts or when there is a recent change in burping habit. Burping at rest is okay, burping because of physical activity signals a blockage.
Why burping occurs during a heart attack
TL;DR: Unexplained and recent burping can indicate a heart issue because the vagus nerve, which runs through the stomach, can be stimulated during a heart attack, causing gastric symptoms like belching.
Unexplained and recent burping can indicate a heart issue because the vagus nerve, which runs through the stomach, can be stimulated during a heart attack, causing gastric symptoms like belching. Angina can manifest as burping.
It is important to consider other symptoms too. Acid reflux, which can cause burping, has been observed in people with coronary artery disease. While burping alone is not a definitive sign of a heart attack, it’s crucial to pay attention to your body and seek medical advice if you have concerns, especially if you have risk factors for heart disease like diabetes, obesity and hypertension.
Curated by James Chen
