[36F] With sudden onset chest pain and difficulty swallowing

Patient Description

A 36-year-old female presents with a sudden onset of chest pain described as a sensation of something stuck in the center of her chest, rated 8 out of 10 in severity, lasting for 2 days. The pain worsens with breathing and is moderately relieved by laying down and taking deep breaths. The patient reports difficulty eating or drinking due to the sensation of food being stuck and has experienced heartburn. The symptoms began immediately after consuming hot chicken soup. There is no history of similar episodes, regurgitation, vomiting, nausea, hoarseness, changes in voice, difficulty swallowing, or radiating pain. The patient has a history of high blood pressure but reports no recent changes in blood pressure readings or related symptoms. No diagnostic tests have been performed to evaluate these symptoms.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Esophageal Spasm or Food Impaction: The sensation of something stuck in your throat and chest, especially after eating, could be due to an esophageal spasm or food impaction. This can cause significant discomfort and pain, and may make it difficult to eat or drink.

    • Treatment: Treatment typically involves medications to relax the esophagus and manage pain. In some cases, an endoscopy may be needed to remove the food impaction.
  • Gastroesophageal Reflux Disease (GERD): Your symptoms of heartburn and chest discomfort could be related to GERD, a condition where stomach acid frequently flows back into the esophagus, causing irritation.

    • Treatment: GERD is often managed with lifestyle changes such as avoiding spicy and acidic foods, eating smaller meals, and not lying down immediately after eating. Medications like antacids, H2 blockers, or proton pump inhibitors may also be prescribed.
  • Esophagitis: Inflammation of the esophagus, which can be caused by acid reflux, infections, or certain medications, might explain the sensation of something stuck in your throat and chest.

    • Treatment: Treatment involves addressing the underlying cause, such as managing acid reflux or treating an infection. Dietary changes and medications to reduce inflammation may also be recommended.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to help manage your symptoms:

  1. Avoid Trigger Foods: Stay away from spicy, acidic, or hard-to-swallow foods that might exacerbate your symptoms.
  2. Eat Smaller Meals: Eating smaller, more frequent meals can help reduce the pressure on your esophagus and minimize discomfort.
  3. Stay Upright After Eating: Avoid lying down immediately after eating to prevent acid reflux. Try to stay upright for at least 2-3 hours after meals.
  4. Hydrate: Drink plenty of water to help ease the sensation of something stuck in your throat and to keep your esophagus moist.
  5. Use MDandMe: Journal your symptoms, track your progress, and get insights. This can help you and your healthcare provider understand your condition better and tailor your treatment plan.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or Worsening Symptoms: If your chest pain or sensation of something stuck in your throat worsens or becomes unbearable.
  • Difficulty Breathing: If you experience significant difficulty breathing or shortness of breath.
  • Inability to Swallow: If you are unable to swallow food or liquids at all.
  • Weight Loss or Fever: If you notice unexplained weight loss or develop a fever.

Remember, while I can provide information and suggestions, it's crucial to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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4 mo ago


People Also Ask


What are the common symptoms of esophageal spasm or food impaction?

Common symptoms of esophageal spasm or food impaction include a sensation of something stuck in the throat or chest, chest pain, difficulty swallowing, and discomfort after eating.


How can GERD be managed effectively at home?

GERD can be managed at home by avoiding trigger foods such as spicy and acidic items, eating smaller meals, staying upright after eating, and using over-the-counter medications like antacids.


What lifestyle changes can help reduce symptoms of esophagitis?

Lifestyle changes to reduce symptoms of esophagitis include avoiding foods that trigger acid reflux, eating smaller meals, staying upright after meals, and ensuring adequate hydration.


When should someone with chest pain seek immediate medical attention?

Immediate medical attention should be sought if chest pain is severe or worsening, if there is significant difficulty breathing, inability to swallow, unexplained weight loss, or fever.

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