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Chest discomfort, nausea, probable esophageal spasm? - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Digestion and Bowels
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2308 Questions
User :   I have chest discomfort. Sometimes it radiates to my left arm to about my elbow. The doctors said I have an ejection fraction of 47%. They put me on lisinopril and to come back in a month. Had an upper g.i. done. Said i have esophageal spasms. It constantly bothers me with chest discomfort even with the meds I am taking. Should I be concerned that something else is wrong? Had a chest x ray and almost a head to toe ct scan.
Doctor :   Hi,
Doctor :   Is the xray and scan normal ?
User :   everything normal...had ekg done
User :   normal as well
Doctor :   is that normal too ?
Doctor :   Ok,
User :   i have an appointment for a second opinion on th ecardio just to be safe
Doctor :   do you have any associated symptom along with pain , like excessive sweating , nausea , headache , palpitation , dizziness etc?
User :   primary sent me to a psychiatrist
User :   no.
Doctor :   Ok, May i know your age and gender ?
User :   maybe palpitation...but that may be esophageal spasms according to g.i.
User :   34 male
Doctor :   Ok do you have hight BP , high cholesterol or Diabetes ?
User :   had a holleter monitor for 24 hours one time tachycardia
User :   no
User :   low hdl is all
Doctor :   ok, Is there any specific time when the pain presents or it is more ?
User :   not really
User :   comes and goes...someday almost no discomfort...other days all day
Doctor :   Is the pain related to exertion ?
User :   no
User :   sitting in car or at home
User :   doesnt matter
Doctor :   Ok., what studies/tests are you being appointed for in the next visit ?
User :   another stress test
User :   just because of the ejection fraction
Doctor :   yes, that would be the first in my list of advice
User :   already did one
Doctor :   i agree , low ejection fraction is one which recommends
Doctor :   when was the last one done ?
User :   with the nuclear medicine
User :   two weeks ago on friday
User :   said nothing to be concerned about.
User :   lisinopril 5 mg
User :   for a month
Doctor :   Ok then if you have got the stress test done and its normal then the unstable angina /other cardiac illness are ruled out
User :   is there something else that can cause these issues
User :   psych said maybe panic attacks...but this is like a constant discomfort
Doctor :   The next one to be rule out is the oesophageal spasms
Doctor :   as it is very typical
User :   had the upper endoscopy
User :   small hiatel herenia and spasms
User :   i want to make sure i am not missing something
Doctor :   I would recommend barometric studies here which will grade the severity so as to link it to the symptom you have
Doctor :   I meant pressure studies in the esophageal lumen
User :   the panic was because i got scared thinking i was having a heart attack
Doctor :   other than the cause in the esophagus i do not think any other cause would be a chance here
User :   so this with the acid can cause the same symptoms as heart attack?
Doctor :   i agree , the pain always resembles heart attack , its the first we have to concentrate on and rule out in situations you are
User :   correct...they did all of that at hospital
User :   i still get concerned when i feel body still tells me heart brain says everything is ok
User :   these symptoms can include the left arm?
Doctor :   no need to worry , as al the tests you have undergone rules out the cause
Doctor :   yes, as i said the esophageal pain resembles heart attach in al ways
User :   one more thing doctor
Doctor :   sweating , nausea dizziness etc
Doctor :   yes , please
User :   usually dont sweat....a little nausea
User :   i sometime get a falling felling when i am in slight sleep
User :   kind of upsets my stomach.... and startles me back to awake
Doctor :   ok, its the tests which will distinguish between the heart and esophageal pain
User :   is that related?
Doctor :   yes, it could be due to esophageal problem
User :   ok....thank for your opinion....i will continue to study until i have this resolved
User :   anything else can cause that falling feeling?
User :   b/p is always go
User :   good
Doctor :   i do not think of any in you , except that the ejection fraction is low as the above symptom can be attributed to the same
User :   anything of concern?
Doctor :   No , the lisnopril will take care of the same
Doctor :   Need not be worried
User :   thank you doctor....
User :   good night
Doctor :   you are welcome
Doctor :   Thanks for consulting me
Doctor :   kindly provide your feedback
Doctor :   Bye for now
User :   youre welcome...i will
Doctor :   take care
Doctor :   Wish you good health
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