Chest Discomfort: Causes and When to Seek Help

Mild discomfort in the chest?

Hello, doctor.
About two days ago, I took anti-inflammatory medication and antibiotics at the clinic due to a cold.
However, the next day, I started feeling a slight, vague pain in the middle of my chest, which is particularly noticeable around meal times.
I also feel a strange sensation when I intentionally burp.
After eating, the discomfort gradually diminishes.
When I visited the doctor yesterday, they mentioned that I might have injured my esophagus because I went to sleep right after eating.
However, I looked online and found that chest pain can have many possible causes, and I thought the esophagus was located in the throat, so I’m confused about why it would cause discomfort in my chest.
I’m a bit worried that there might be an issue with my lungs or heart and whether I should see a pulmonologist.
I’ve also been seeing news about aortic dissection and sudden death, which makes me anxious about my own situation, especially since I haven’t been vaccinated yet.
Lastly, I would like to ask how long it typically takes for esophageal issues to resolve, as today marks about the fourth day of my symptoms.
Thank you!

Ho, 20~29 year old female. Ask Date: 2021/08/26

Dr. Hong Yuanbin reply Internal Medicine

Hello, the esophagus is quite long, extending from the throat to the chest.
Based on your description, it is possible that you are experiencing gastroesophageal reflux disease (GERD) or a gastric ulcer.
However, the exact cause can only be determined through an endoscopy.
As for aortic dissection, it typically presents with severe tearing pain and does not alleviate with eating, which seems unlikely in your case.
GERD or gastric ulcers are usually chronic issues.
I recommend establishing a regular routine, engaging in regular exercise, and maintaining a balanced diet.
Avoid lying down within one hour after meals and refrain from using anti-inflammatory medications and coffee.
If discomfort persists, you should consider undergoing an endoscopy for diagnosis, and medication may be necessary for improvement.
It would also be a good opportunity to check for Helicobacter pylori infection.
Thank you for your inquiry.

Reply Date: 2021/08/26

More Info

Chest discomfort can be a concerning symptom, and it's understandable that you're feeling anxious about it, especially given the recent news about serious health issues. Let's break down your situation and provide some clarity on the potential causes of your symptoms, as well as when to seek further medical help.

From your description, it seems that your chest discomfort began after taking medication for a cold and possibly after eating, especially when you were lying down. This raises the possibility of esophageal irritation or injury, which can occur if food or medication irritates the esophagus, particularly if you lie down immediately after eating. This is sometimes referred to as "esophagitis" or "reflux esophagitis," where the lining of the esophagus becomes inflamed.

The esophagus is indeed located in the throat area, but it extends down into the chest, which is why you might feel discomfort in the center of your chest. Symptoms of esophageal issues can include pain or discomfort in the chest, especially during or after eating, and it may feel worse when lying down. This discomfort can sometimes mimic heart-related pain, which is why it’s essential to be vigilant about any chest pain.

You mentioned that the discomfort is more pronounced around meal times and lessens afterward, which aligns with esophageal irritation. However, it’s crucial to rule out other potential causes of chest pain, such as cardiac issues, especially if you have risk factors like a family history of heart disease, smoking, or other health conditions.

Given your concerns about serious conditions like aortic dissection or heart problems, it’s wise to be cautious. If you experience any of the following symptoms, you should seek immediate medical attention:
1. Severe chest pain that feels like pressure, squeezing, or fullness.

2. Pain radiating to the arms, back, neck, jaw, or stomach.
3. Shortness of breath, sweating, nausea, or lightheadedness.
4. Symptoms that worsen or do not improve with rest.
If your symptoms are mild and primarily related to eating, it may be more appropriate to monitor them for a few days. If the discomfort persists beyond a week or worsens, or if you develop new symptoms, it would be advisable to consult a healthcare professional, possibly a gastroenterologist or a pulmonologist, depending on the symptoms.

As for recovery from esophageal irritation, it can vary. Many people find relief within a few days to a week with appropriate care, which may include dietary modifications (avoiding spicy, acidic, or very hot foods), not lying down immediately after eating, and possibly taking medications to reduce stomach acid if recommended by your doctor.

In summary, while your symptoms could be related to esophageal irritation, it’s essential to remain vigilant and seek medical advice if you have any concerns about your heart or if your symptoms change. It’s always better to err on the side of caution when it comes to chest discomfort. If you have any further questions or if your symptoms change, don’t hesitate to reach out to a healthcare provider.

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