The most common signs and symptoms of heartburn include:

• Burning sensation in the middle of the chest that begins at the breastbone and moves up toward the throat.
  
  
• Sensation of food or beverage coming back into the throat or back of the mouth.
  
  
• Bitter or acidic taste in the back of the throat.
  
  
• Increase in pain behind the breastbone, particularly when lying down or bending over.

Patients who experience any of the following symptoms should consult a physician because it may indicate that the esophagus has been damaged due to chronic heartburn. They include:

• Symptoms that persist even after treatment.
  
• Symptoms that worsen over time.
  
• Dysphagia (difficulty swallowing).
  
• Bleeding. This can include vomiting blood or having bloody stool.
  
• Shortness of breath, coughing or hoarseness of the voice.
  
• Unexplained weight loss.

The symptoms of heartburn are sometimes confused with symptoms of a heart attack or angina (chest pain caused by reduced flow of blood to the heart muscle). Symptoms of a heart attack or angina may include:

• A feeling of fullness or tightness, or a dull or crushing pain in the center of the chest. These symptoms often occur with activity or exertion.
  
  
• Pain that spreads to the shoulders, neck, arms or jaw.
  
  
• Pain in the chest may be accompanied by an irregular heartbeat, cold sweat, shortness of breath, nausea, vomiting, lightheadedness, weakness or dizziness.
  
  
• Symptoms often respond quickly to nitroglycerin (medication used to relax and dilate blood vessels and improve blood flow).