How can i distinguish between a heart attack and acid reflux?

Multiple possible: Not sure if you're asking the cause of the chest pain. If that's the case, a thorough history and physical examination, by your primary physician, can typically narrow down the possibilities. I don't see an age on your profile, so its' difficult to tell how concerned. Basically, if you're concerned, don't risk it. If you feel it might be a heart attack, or something else dangerous, call 911.