Is there a way to tell the difference between the vomiting from angina and that from anxiety or bad food?

“Angina vomiting would be similar to any form of angina; that is, it would be brought on by physical activity or severe emotional stress and go away when the stress is removed,” says Donna P. Denier, MD, of The Cardiology Center with the Appalachian Regional Healthcare System.

“It would typically be associated with chest pain (but not always), sweating, difficulty breathing or other signs of a heart attack.”

Bad Food

“Vomiting caused by bad food will usually start just after eating the food, be accompanied by abdominal cramping and/or diarrhea.

“True food poisoning may include fever and chills and the vomiting will be very copious until the stomach is emptied.”

One time when I gorged on pizza loaded with ground beef, I upchucked rather copiously.

When my mother vomited two days before a catheter angiogram showed life-threatening blockages in her coronary arteries, it was just a few gobs of goop in the waste can, but nonetheless, it was vomitus. And there’d been no abdominal cramping or diarrhea.

Nevertheless, Dr. Denier says, “These scenarios can be very similar in real life and even a doctor cannot always tell the difference right away.

“A bad gall bladder episode can look just like a heart attack! Any concerning symptoms should always be reported to your doctor.”

Vomiting from anxiety is uncommon. Don’t confuse anxiety with viewing a stomach-turning scene—anxiety is not the same as being “grossed out.”

I’m talking about anxiety from job stress, an unhealthy relationship, worrying about debt—just the classic chronic anxiety.

Vomiting from Unstable Angina

“Vomiting related to unstable angina is caused by stimulation of the autonomic nervous system,” begins Dr. Denier.

“In unstable angina, there is a severe blockage of blood flow to the heart. The heart is starved of oxygen and it is under stress because of that.

“When the body or parts of the body are under stress, the autonomic nervous system is triggered. This can result in vomiting, sweating and clammy skin.”

My mother had quintuple bypass surgery three days after mysteriously upchucking the goop; not the typical volume of vomitus that you’d see from bad food.

It was morning, prior to breakfast, and she hadn’t had that much food the previous day.

Dr. Denier says, “Unstable angina is a sign of an impending heart attack.” Three doctors told me that my mother would likely have a massive heart attack within a week without the bypass.

“In some cases, sweating and vomiting may be more significant symptoms than chest pain,” adds Dr. Denier.

“In fact, some patients have no chest pain at all. That is why unexplained vomiting should be taken seriously.” Even if the person has anxiety.

donna denier, md

Dr. Denier has been practicing medicine for over 15 years and is board certified by the American Board of Internal Medicine – Cardiovascular Disease.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.