Esophageal spasm needs diagnosis

DEAR DR. ROACH: I am a 72-year-old woman. For many years, or even decades (but infrequently, like every few months), I have experienced sudden chest pressure or tightness while eating my evening meal.

Out of the blue, I feel extreme pressure or tightness in my chest, and I must stop eating and take a few deep breaths. It then goes away and I finish my supper. I used to wonder if it was because I had eaten too fast, but I always do! I eat a fairly large lunch and supper, but primarily healthy, high-fiber foods.

My guess is that it might be a cardiac symptom, though I exercise daily and am very fit for my age. Or could it be some kind of esophageal spasm? -- W.S.

ANSWER: It does sound to me like it probably is coming from the esophagus or stomach. However, heart symptoms can come on while eating, and it is always wise to consider chest symptoms as possibly heartrelated. The fact that it has been going on for so long is reassuring, but I still would recommend that you visit your doctor for an evaluation. Esophageal spasm and its related conditions usually are diagnosed by measuring the pressures in the esophagus through a test called “esophageal manometry.”

Women are less likely to have typical symptoms of blockages in the arteries to the heart, so I take women’s symptoms seriously. If you had these symptoms alongside exercise, I would be much more concerned.