Reflux can cause burning chest discomfort and regurgitation, but heart attack pain carries a different risk profile. The rule is simple: new chest pain that feels like pressure/crushing, worsens with exertion, or comes with sweating, shortness of breath, nausea, arm/jaw radiation, or faintness must not be dismissed as reflux. Reflux often worsens after meals, when lying down, or bending forward, and may partially respond to antacids—yet this is not definitive. If cardiovascular risk factors exist (smoking, hypertension, diabetes, family history), seek urgent evaluation with a low threshold. The safest approach is to rule out cardiac causes first when uncertainty exists.