Angina or esophageal spasm

                   I have got many ecg's,stress test,upper scope and lower gi done and all they said it was gerd .Heart looked fine bloodwork etc.I'am still having these chest pain mostly between 3-10 pm mostly when im doing nothing.And they said it was Esophageal spasms giving me the pain,but what i cant understand the pain comes just as bad when i dont eat,feels like a emty dull feeling in my chest last from 5-15 mins.Most of the time it runs me to the er and the time i get there its gone or stable.It seems so hard to seperate Angina from Spasms anybody have any idea's the stress test could miss stuff i guess.what do i need to look for lol they give you nitro for angina and espasms.How do i understand the differance since the med's are the same for both.But it seems to get worse on a emty tummy or when i'am resting

[joanincarolina]

It is difficult to discern spasms of the esphagus and the heart.Yes nitro works on both.I've had cardiac spasms for 5 years and while I was consistently steered away from cardiac origin I now consider myself knowledgeable in defining the spasms of the heart and finally had a spasm seen on a cath. Otherwise, they are hard to catch and a doctor must listen carefully to your description.Spasms come with no real relationship to anything. They are quick, sharp, travel ( mine tend to start at a bottom point and go upward) and stop you in your tracks.They are in the area over the heart, more left of sternum as the origin can be from either of the coronary arteries.There is a residual ache/burn for a while...sometimes up to a 1/2 hour plus. I wear nitro patch and take a calcium channel blocker to settle down the vessels. You can take nitro tab when they happen to help with residual pain but otherwise it's like trying to figure out what some triggers are that lead to a spasm and keeping nitro handy.Hope this helps. Joan.

[Bullet1980]

                          Yep i didnt tell you were in the the pain was coming.mines in the middle of my chest about 5-6 inches down from my throat.and like today i havent had any kind of strong attack but i fell a little dull pain geting stronger then going down so much i  dont feel anything.they put me on anixtey meds and panic attack meds that junk dosnt work,i think it slows how many epsoides i get in a week but nothing helps pain killer's seem to make it worse,when they gave me morfine in the er it made the pain worse for 5 mins then it went away.it's crazy when will i find a doctor that will find out the true problem is what i keep asking myself

[joanincarolina]

That's a better description of esophageal spasm.I would pay attention to those things and medications for GERD, diet, amount of food, not smoking or being around smoke, bubbly drinks, spicy things.You really have to get a balance on that hygiene that affects the food tube and stomach.The upper GI and scope you had done eliminates the hiatal hernia aspect and any obstructions. The pain from any type of spasm, like a charley horse, hurts. Check out archives in other forums on Digestive/Stomach problems and see if others can give you some further tips. Try it for a while and then re-address a cardiac origin as needed. Joan.

[kenkeith]

The diagnosis of esophageal pain should be entertained only after angina and infarction are ruled out. No tests are available in the acute setting that can reliably prove esophageal pain, and you are correct, nitro, treats both conditions.  There are no physical, lab, or x-ray findings that are typical for esophageal pain. The presence of an air-fluid level in a hiatal hernia on chest x-ray isn’t helpful in proving the cause of pain —

Your post indicates a new onset of symptoms after having been diagnosed with esophogeal reflux/spasm.   However, the diagnosis of new-onset esophageal pain should be entertained only after angina and infarction are ruled out. No tests are available in the acute setting that can reliably prove esophageal pain.  It does present a dilemma...is the new onset angina or esophageal pain and whether to go or not go to ER!   If your stress test didn't indicate any CAD the probability would favor esophogus problem, but you should present the dilemma to your doctor to be safe.  

[Bullet1980]

                                         I do have a Hital hernia that they found in the scope.they said it was small not to worry about it.Could that cause all of this pain? i havent had the Pain in 30 hours been kinda dull not hurting to bad but when it hits it make a big man want to cry and it scare's me so much. ty u2 Lady's for your support. i will keep going to i find out for sure