As people age, a particularly spicy meal can bring on chest pain. So the fear becomes: Is it indigestion or a heart attack?

It is often easy to confuse symptoms of indigestion, esophageal problems, acid reflux disease, muscle spasms or pneumonia and other lung problems with those of a heart attack, according to cardiologist Alex Durairaj, M.D., assistant professor of clinical medicine at the Keck School of Medicine of USC.

"The nerves on the inside of the body are not as accurate as the nerves on your skin," says Durairaj. "The brain sometimes misinterprets esophageal pain as cardiac pain, for example."

There are symptoms that are more indicative of a cardiac event, he says, for example, a feeling of heavy pressure in the chest and a tightening sensation extending into the left arm or throat. Associated symptoms also may be breathing difficulty, sweating or palpitations.

Durairaj cautions that if the pain persists after 15 minutes, seek medical help immediately, either by calling 911 or going to the emergency room. Heart attacks treated within the first hour offer the best outlook for saving heart function and minimizing damage.

At the emergency room, patients should volunteer information about their own risk factors such as smoking, diabetes, hypertension or family history of heart disease, so the physician can determine the likelihood of a heart attack and what tests to administer.

Often, gastrointestinal medicines administered to the patient result in diminished pain.

"The GI medicine can sometimes reduce heart attack pain or has .a placebo effect," he says.

Even if the pain is thought to be gastrointestinal in nature, patients should follow up with a cardiologist to discuss personal heart disease risk, determine if any danger exists and decide what steps to take to control it.