Chest pain when swallowing

Introduction Chest pain caused by esophagitis, hiatal hernia, diffuse esophageal fistula, and esophageal tumor often occurs or worsens when swallowed. Esophagitis is an inflammation caused by edema and congestion of the esophageal mucosa due to abnormal stimulation of the superficial or deep tissue of the esophageal mucosa. Esophageal hiatus refers to a disease caused by the intra-abdominal organ (mainly the stomach) entering the chest through the hiatus of the esophagus. Esophageal hiatus hernia is the most common in sputum, reaching more than 90%. Esophageal hiatus occurs more than 40 years old, and women (especially obese women) are more than men.

Cause

Causes of chest pain during swallowing: seen in esophageal diseases such as esophagitis, esophageal hiatal hernia, chest pain caused by esophageal tumors. Dysphagia can also be accompanied by a fixed pain, mostly for mediastinal involvement, often with weight loss, and severe malnutrition. Cases with heavy reflux may have signs of the lungs.

Chest pain after exertion: Coronary heart disease angina pectoris, is the most common cause of chest pain, mostly after exertion, full meal, emotional excitement.

an examination

Related inspection

Chest perspective chest MRI

Physical examination of the physical signs should pay attention to the patient's nutritional status, with or without anemia, superficial lymphadenopathy, goiter, neck mass, abnormal swallowing muscle activity, etc., if necessary, a neurological examination to identify the cranial nerves associated with swallowing ( IX, X, XII on the cranial nerve), swallowing muscles are abnormal. The drinking water test patient takes a sitting position, and the stethoscope is placed between the patient's xiphoid process and the left rib arch, and a sip of water is given. The normal person can hear the jet murmur after 8-10 s. If there is esophageal obstruction or movement disorder, it will not be heard. Sound or delay appears, and severe obstruction can even vomit water. This method is simple and easy, and can be used as a method for initially identifying the presence or absence of obstruction of the esophagus.

Differential diagnosis

Differential diagnosis of chest pain during swallowing:

1, atypical chest pain: atypical chest pain, its chest pain symptoms are not typical, clinical chest pain, chest discomfort is a common symptom, its clinical manifestations vary. Such as stomach pain, neck pain, toothache, sore throat and so on.

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

3, smoking chest pain: 20 to 30 years old thin high-male male is the main predileous group of spontaneous pneumothorax, most patients have family tendencies and smoking habits. According to statistics, the rate of diarrhea among smokers is nine to eleven times higher than that of non-smokers. Patients have chest pain, chest tightness, and shortness of breath, and the majority of chest pain is manifested. Due to the young, tall and thin reasons, patients often do not care, ignoring the importance of medical examination.

4, chest pain after exertion: coronary heart disease angina pectoris, is the most common cause of chest pain, mostly after exertion, full meal, emotional excitement.

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