Why is acid reflux (allegedly) often confused with chest pain?

Question

I get irregular, sharp, short bursts of pain in my chest, on the left side, near my heart. Supposedly, heart and circulatory related pain is neither sharp nor short, so this pain may be muscle or lung-lining related. (I also haven't had any shortness of breath, nausea, or fatigue).

I've had plenty of acid reflux over the years (stomach acid gets into my throat and burns like crazy until addressed), and I just don't understand why, whenever I try to look for information about my mystery chest pain, I'm forced to hear about something as seemingly irrelevant as acid reflux.

It's like calling tech support and they ask you if your computer's plugged in. Am I missing something here? Can acid reflux cause actual chest pain, and not just esophageal pain? If it can, then how? I'm under the impression that the digestive system is a closed system, and that a stomachache shouldn't cause, say, shoulder pain or a backache.

(edit: I found somewhat similar question, and it's answers mention esophageal spasms, but are such symptoms common enough to be relevant, and would they actually cause chest pain? would it not be obvious that the source of the pain is the esophagus?)

Answer 1

The average person has never felt chest pain of cardiac origin so has no idea what it "should" feel like, and therefore they have no way of knowing how to distinguish it from other sources of chest pain.

Yes, reflux causes actual chest pain in some people. Just because you can easily recognize it as reflux doesn't mean everyone can. What if you've felt reflux before, but the pain seems a bit different this time? Do you just wave it off and hope you're right?

Esophageal spasms can be intensely painful, and if it's the first time you've felt it how would you know what it was?

But perhaps most importantly, the very notion of what cardiac chest pain "should" feel like is a dangerous generalization created by Hollywood and urban legend. Cardiac chest pain comes in a wide range of varieties, many of which can be mimicked by reflux, esophageal spasm, muscle strains, spinal problems, pleurisy, and a dozen other conditions. It can be sharp or dull; it can be more like a pressure than actual pain; it can radiate to one or more arms, the jaw, shoulders, or back. In fact, it might be felt somewhere other than the chest entirely, or there may be no pain at all. So-called silent heart attacks are not unusual, especially in diabetics, women and the elderly.

So, no, distinguishing cardiac chest pain from other sources is neither easy nor obvious. Walk into any ER (A&E) the world over complaining of chest pain, and they will work you up under the assumption that it is of cardiac origin until that possibility has been ruled out. Nobody ever died from misdiagnosed reflux, but they most certainly have died of misdiagnosed chest pain.

https://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/signs