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    Suggest treatment for tightness sensation in the chest

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Posted on Mon, 7 Aug 2017 in Digestion and Bowels
Question: I am having tightness in my chest and it feels like something is stuck in my esophagus. I do not have heartburn and it is uncomfortable enough to wake me up in the middle of the night. I can feel it in the front of my chest, right above my sternum.
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Answered by Dr. Ramesh Kumar 33 minutes later
Brief Answer:
can be angina or gastric pain.

Detailed Answer:
Hello,
Thank you for choosing HealthcareMagic for your query.

Have gone through your query in detail and i appreciate your concerns.

See there can basically be two possibilities-
First one is it can be gastric in origin (heartburn is a symptom and is not necessarily present in every patient).
A thin area of narrowing in the lower esophagus can intermittently cause difficulty swallowing foods. So my primary differential in your case is Gastroesophageal reflux disease and achalasia cardia. As per standard text books one of the classical complaint of patient of GERD or achalasia is -"feel like i have food stuck in throat or like food is choking or throat is tight." (Exactly the same feeling you are having). In case of GERD the acid produced in stomach is refluxed back into esophagus. The mucosa lining of esophagus is constantly irritated by acid leading to scarring of a particular area. This scarring leads to narrowing of the esophageal cavity hence food when swallowed feels like stuck in throat.As the acid constantly irritates esophagus it causes severe inflammation and fibrosis. Achalasia is a serious condition that affects your esophagus. The lower esophageal sphincter (LES) is a muscular ring that closes off the esophagus from the stomach. If you have achalasia, your XXXXXXX fails to open up during swallowing, which it’s supposed to do. This leads to a backup of food within your esophagus. This condition can be related to damaged nerves in your esophagus. It can also be due to damage of the XXXXXXX

Second possibility is angina-- Angina is chest pain or discomfort caused when your heart muscle doesn't get enough oxygen-rich blood. It may feel like pressure or squeezing in your chest. The discomfort also can occur in your shoulders, arms, neck, jaw, or back.

Both cardiac and gastric symptoms mimic each other so its extremely difficult to tell you the exact diagnosis just by going through a small history.

We have to investigate you to rule out the chief cause in your case.
Tests suggested are-
High-resolution esophageal manometry. Using a catheter inserted down your esophagus, muscle contractions in your esophagus are measured when you swallow water.
Endoscopy- To visualise esophagus and stomach.

From cardiac side tests suggested are
Stress test and 2d echo-To rule out coronary artery disease.In coronary artery disease blood supply to heart is hampered hence causing pain in chest.
Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2426 Questions

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