What Causes Chest Pain when Swallowing?

Chest pain caused by esophagitis, esophageal hiatal hernia, diffuse esophageal spasm, and esophageal tumors during swallowing often occur or worsen during swallowing. Rest in bed and take a free position. For those caused by pleurisy, lying on the affected side can reduce pain.

Chest pain when swallowing

Causes of chest pain when swallowing: Found in esophageal diseases such as esophagitis, hiatal hernia, and chest pain caused by esophageal tumors. Difficulty swallowing can also be accompanied by fixed drilling pain, most of which are signs of mediastinal involvement. Physical examination often results in weight loss, and severe cases lead to malnutrition. Cases with severe reflux may have lung signs.

Chest pain after exertion: Coronary heart disease, angina pectoris, is the most common cause of chest pain, and it usually occurs after exertion, full meals and emotional excitement.

Physical examination should pay attention to the nutritional status of the patient, whether there is anemia, superficial lymph node enlargement, goiter, neck mass, abnormal swallowing muscle activity, etc., if necessary, perform a neurological examination to identify the brain nerves related to swallowing , , on the brain nerve), swallowing muscles are abnormal. Patients in the drinking test take a seated position, place the stethoscope between the patient's xiphoid process and the left costal arch, and ask for a sip of water. Normal people can hear jet noises after 8 to 10 seconds. The sound may be delayed, and even severe obstruction can vomit water. This method is simple and easy to use, and can be used as a preliminary method to identify the presence or absence of esophageal obstruction.

Differential diagnosis of chest pain when swallowing:

1. Atypical chest pain: Atypical chest pain, the symptoms of which are atypical, chest pain and chest discomfort are common symptoms in clinic, and their clinical manifestations are different. Such as stomach pain, neck pain, toothache, sore throat and so on.

2. Chest pain after a full meal: Chest pain after a full meal is a major manifestation of spontaneous esophageal rupture. Spontaneous Rupture of Esophagus refers to a sudden increase in pressure in the lumen of the esophagus due to various reasons, which causes a longitudinal tear of the entire left side wall of the esophagus on the adjacent diaphragm. Also known as Boerhaave syndrome, spontaneous esophageal laceration syndrome, pressure rupture of the esophagus, digestive perforation of the esophagus, and non-traumatic esophageal perforation. Most occur after drinking and vomiting.

3. Smoking chest pain: Tall and thin young men between the ages of 20 and 30 are the dominant group of spontaneous pneumothorax. Most patients have family tendencies and smoking habits. According to statistics, the prevalence of illness among smokers is nine to eleven times higher than that of nonsmokers. Patients will feel chest pain, tightness, and shortness of breath, and the majority of them are manifested by chest pain. Because of the young, tall and thin body, patients often do not take it seriously and ignore the importance of medical examination.

4. Chest pain after exertion: Angina pectoris due to coronary heart disease is the most common cause of chest pain. It usually occurs after exertion, full meals and emotional excitement.

Prevention of chest pain when swallowing:

Emergency response

1. Rest in bed and take a free position. If it is caused by pleurisy, lying on the affected side can reduce pain.

2. Local hot compress.

3. Oral analgesics, aspirin 0.3 ~ 0.6g, 3 times a day; paracetamol 0.25 ~ 0.5g, 3 times a day, or indomethacin 25mg, 3 times a day. If added with diazepam 5mg, 3 times a day, the effect is better.

4. If you have suspected angina pectoris, you can take nitroglycerin or Xiaoxintong 5 ~ 10mg or 10% 14 tablets of quick-acting Jiuxin pills under the tongue, and then dial 120.

5. When the pain is still not relieved after the above emergency treatment, the hospital should be rushed to the hospital for emergency treatment.