The heart and stomach are not far apart, and often angina is painful in a large area or in the thoracic part of the body, making it difficult to determine whether it is angina or stomach pain in many cases. Here’s how to distinguish between the two. When does it hurt? Common triggers for angina are exertion, emotional stress, and cold. The pain usually occurs at the time of activity, and in some patients it occurs regularly in the middle of the night or early morning, lasting several minutes or more, and can be relieved by rest or medication. Stomach pain, on the other hand, often occurs before or after meals. Where does it hurt? The typical site of angina is behind the middle of the chest, and the pain is about the size of a fist or the palm of the hand, and can involve the precordial area or the back of the sternum, sometimes radiating to the teeth, left shoulder, left arm, throat or upper abdomen. Stomach pain, on the other hand, usually occurs in the upper abdomen. How does it hurt? About 60% of people with angina present with crushing or clenching pain, often accompanied by anxiety or a near-death fear. Some patients also describe the pain as burning or dull, but rarely describe it as pins and needles or knife-like pain. If the pain is tossing and turning, tossing and turning is usually not angina. How long does the pain last? Angina is mostly paroxysmal and lasts 3 to 5 minutes, usually no more than 15 minutes or half an hour. Pain that lasts more than a few hours or days, or pain that lasts only a few seconds, is generally not angina pectoris. The duration of stomach pain is variable and depends on the condition of each individual. How to relieve it? Angina is usually relieved after the trigger is removed, or within 3 minutes with sublingual nitroglycerin. Stomach pain requires medication based on the patient’s symptoms. Many middle-aged and elderly people are prone to mistakenly treat heart disease as stomach disease, thus delaying a better treatment period. If middle-aged and elderly people suddenly have chest pain or epigastric pain, do not easily conclude that it is stomach pain, but should first consider the possibility of angina pectoris or myocardial infarction. If the pain is relieved after taking nitroglycerin or quick-acting heart pills under the tongue, most of them are heart disease and should go to the hospital for further examination and treatment as soon as possible.