Esophageal spasm needs di­ag­no­sis

Cape Breton Post - - Obituaries/Advice/Games - Keith Roach Email ques­tions to ToYourGoodHealth@ med.cor­nell.edu (c) 2017 North Amer­ica Syn­di­cate Inc. All Rights Re­served

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.

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