Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Chest Pain And Difficulty In Swallowing?
Question: I have been having mid chest pain intermittently. I have noticed when I swallow today, it feels as if something is blocking the way mid sternum. The pain is dull at the moment and earlier this morning I used my QRI thinking I was having asthma symptoms. I have no other symptoms this afternoon but felt my heart was palpitating earlier with some SOB. No fever, no cough, no sore throat. Discovered yesterday I am low on iron and B12 and my NP has ordered methyl B12 and methyl folate since she does not think I am making XXXXXXX
Brief Answer:
GERD, ASTHMA, VOCAL CORD DYSFUNCTION
Detailed Answer:
Hello
Thanks for your query.
The feeling of blocking something in the mid sternum with mild dyspnea may be because of different reasons like gastro-esophageal reflux diseases (GERD), asthma, vocal cord dysfunction syndrome and mediastinal disorders. GERD is very common in occurrence and for which you may have a course of pantoprazole tablet twice daily before food along with life style modification like water intake 3-4 liter daily, avoidance of fatty, spicy, fast food, frequent but small amount of bland diet, head end elevation during sleep. There is a objective test to diagnose it. The name of the test is 24 hour esophageal pH monitoring which you may undergo if facilities permit. Otherwise initially you should have a trial of pantoprazole for 7 days and look for the improvement. You should have a recheck of your asthma control again. Also you ideally should go for a contrast enhanced computed tomography (CECT) scan of thorax to exclude mediastinal abnormality. For vocal cord dysfunction syndrome which is not rare in female, you should undergo a laryngoscopic examination to look for the vocal cord movement during symptoms. You also should undergo a spirometric examination which will assess your symptoms and will aid in the diagnosis of vocal cord dysfunction syndrome. Ideally this should be the approach scheme for your problem. You should consult your pulmonologist and discuss this issues. Also you should consult your psychiatrist to assess your mental function.
If you have further queries you can ask me.
If you are happy with my response you can write a review for me.
Get well soon. God bless you.
Regards
Dr Arnab Maji
MBBS, MD
Consultant Pulmonologist
GERD, ASTHMA, VOCAL CORD DYSFUNCTION
Detailed Answer:
Hello
Thanks for your query.
The feeling of blocking something in the mid sternum with mild dyspnea may be because of different reasons like gastro-esophageal reflux diseases (GERD), asthma, vocal cord dysfunction syndrome and mediastinal disorders. GERD is very common in occurrence and for which you may have a course of pantoprazole tablet twice daily before food along with life style modification like water intake 3-4 liter daily, avoidance of fatty, spicy, fast food, frequent but small amount of bland diet, head end elevation during sleep. There is a objective test to diagnose it. The name of the test is 24 hour esophageal pH monitoring which you may undergo if facilities permit. Otherwise initially you should have a trial of pantoprazole for 7 days and look for the improvement. You should have a recheck of your asthma control again. Also you ideally should go for a contrast enhanced computed tomography (CECT) scan of thorax to exclude mediastinal abnormality. For vocal cord dysfunction syndrome which is not rare in female, you should undergo a laryngoscopic examination to look for the vocal cord movement during symptoms. You also should undergo a spirometric examination which will assess your symptoms and will aid in the diagnosis of vocal cord dysfunction syndrome. Ideally this should be the approach scheme for your problem. You should consult your pulmonologist and discuss this issues. Also you should consult your psychiatrist to assess your mental function.
If you have further queries you can ask me.
If you are happy with my response you can write a review for me.
Get well soon. God bless you.
Regards
Dr Arnab Maji
MBBS, MD
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I did not mention I have been a Registered Nurse for 23 years. Because of my gastric bypass - I do not make hydrochloric acid in my stomach and being seven years post op, my malabsorption of important nutrients is lacking so taking something for GERD is not applicable. This was an acute situation that lasted but 18 hours and I am convinced it was taking too much Buproprion while waiting for my XL RX (my bad - nurses are the worst patients).
After two days using my inhaler, I no longer am feeling the tightness in my chest or when I swallow and I will be trying Betaine XXXXXXX for my malabsorption issues to see if it has improved by my next lab in six months.
I am working with my NP and see her regularly for nutritional labs. Because it is springtime, it may have been asthma and taking more Wellbutrin than ordered exacerbated the situation by causing some anxiety.
Thank you for your recommendations and all's well that ends well...I am so glad you returned my question - I thought this was a scam. I have cancelled my subscription and while I have a 30 day "membership", I will no longer need your services.
XXXX
After two days using my inhaler, I no longer am feeling the tightness in my chest or when I swallow and I will be trying Betaine XXXXXXX for my malabsorption issues to see if it has improved by my next lab in six months.
I am working with my NP and see her regularly for nutritional labs. Because it is springtime, it may have been asthma and taking more Wellbutrin than ordered exacerbated the situation by causing some anxiety.
Thank you for your recommendations and all's well that ends well...I am so glad you returned my question - I thought this was a scam. I have cancelled my subscription and while I have a 30 day "membership", I will no longer need your services.
XXXX
Brief Answer:
Thank you
Detailed Answer:
Hello
Thanks for your feedback.
Thank God that everything is going well now. Therefore you just have to carry on what you are taking and do have regular follow up to your doctors.
God bless you.
Thank you.
Regards
Dr Arnab Maji
Thank you
Detailed Answer:
Hello
Thanks for your feedback.
Thank God that everything is going well now. Therefore you just have to carry on what you are taking and do have regular follow up to your doctors.
God bless you.
Thank you.
Regards
Dr Arnab Maji
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
