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Feel heaviness in the shoulder blades. Diagnosed slight hiatal hernia. Should I go to ER?

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General & Family Physician
Practicing since : 2011
Answered : 589 Questions
I feel like I can hardly swallow and I feel like there is somethin grabbing my insides between my shoulder blades... like a heaviness inside. Could I have a strangulated hiatal hernia? I burp to relieve gas ALOT... Ive seen a gastroenerologist a year ago... he said I had a slight hiatal hernia... but this problem is getting worse.. I am wondering if I should go to ER. It is not heart problems. No pain... burping burping... and restricted swollowing.What test can be done to show if a hiatal hernia is being strangulated?

Posted Wed, 24 Jul 2013 in Digestion and Bowels
Answered by Dr. Guru 1 hour later

Thank you for consulting HealthcareMagic!

I am sorry for your problem. Hiatal hernia, when small is usually asymptomatic but a large hernia can cause symptoms like frequent heartburn, difficulty swallowing etc. Your symptoms seems to be due to mechanical obstruction at some level in upper part of gut. It can also be due to strangulation of hiatal hernia.

There are certain complications of hiatal hernia which are usually due to frequent acid reflux into esophagus which may cause ulcers and over a long period of time may lead to stricture. Other possible complication is strangulation which usually presents as sudden severe sharp upper abdominal pain and shortness of breath.

Upper GI Studies with barium suspension is one of the important investigation used in diagnosing hiatal hernia and its complications. Endoscopy is helpful in pin-pointing upper gastro-intentinal disorders.

However, in your case we need to rule out some other possibilities as well. There are some conditions like aortic aneurysm, myocardial infarction which need to be excluded though you do not have any chest pain. Many heart problems unlike you are thinking will not have chest pain but they can sometimes present as heaviness in chest as you have. So, I think that you may go for an emergency evaluation and treatment. You may get an ECG, etc. to rule out heart conditions.

Hope it helps!
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