Chest Pain and Throat Discomfort: A Guide to Rehabilitation Care

Q: Chest Pain and Throat Discomfort: A Guide to Rehabilitation Care

Hello, sir： Thank you for your inquiry. <br>I would like to respond to your question and provide the following suggestion： I recommend that you first consult an otolaryngologist (ENT specialist). <br>Large hospitals have more specialized departments, and there are doctors who foc

Examination

Hello Dr.
Chen, I would like to ask you a question.
A few days ago, I experienced severe pain in my left chest and went to the emergency department at Mackay Memorial Hospital in Hsinchu.
Due to my hypertension, I had blood tests and an electrocardiogram, but no cause was found.
After my symptoms improved, I noticed that my snoring at night became worse, and I felt a sensation of something stuck in my throat, which was very uncomfortable.
It’s manageable when I’m not eating, but after meals or drinking water, the sensation of something stuck in my throat becomes quite bothersome.
A physician at a clinic suggested that I go to a larger hospital for further examination, but I’m unsure which department to visit and what tests I should undergo to alleviate these symptoms.

Zhao Rui, 30~39 year old female. Ask Date: 2008/09/11

Dr. Chen Xianchang reply Rehabilitation

Hello, sir: Thank you for your inquiry.
I would like to respond to your question and provide the following suggestion: I recommend that you first consult an otolaryngologist (ENT specialist).
Large hospitals have more specialized departments, and there are doctors who focus specifically on laryngology.
They have various endoscopes to closely examine the area around the epiglottis.
Finally, I wish you peace and happiness!

Reply Date: 2008/09/11

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your recent experiences with chest pain and throat discomfort. It’s understandable to feel anxious when faced with such symptoms, especially given your history of hypertension. Let’s break down your situation and explore the potential avenues for rehabilitation and further evaluation.

Firstly, it’s important to recognize that chest pain can arise from a variety of causes, including musculoskeletal issues, gastrointestinal problems, or even anxiety. Since you have already undergone an evaluation in the emergency department, including blood tests and an electrocardiogram (EKG), and no acute cardiac issues were identified, we can consider other possibilities.

The discomfort you’re experiencing in your throat, particularly the sensation of having something stuck, is often referred to as "globus sensation." This can be associated with several conditions, including gastroesophageal reflux disease (GERD), anxiety, or even muscle tension in the throat. The fact that you mentioned your snoring has worsened at night could also suggest that there may be an obstructive component, possibly related to sleep apnea, which is common in individuals with hypertension.

Given your symptoms, I would recommend the following steps:
1. Consultation with an Ear, Nose, and Throat (ENT) Specialist: An ENT can evaluate your throat discomfort more thoroughly. They may perform a laryngoscopy to visualize your throat and assess for any abnormalities. This specialist can also check for any signs of inflammation or structural issues that might be contributing to your symptoms.

2. Gastroenterology Evaluation: Since you mentioned that eating or drinking exacerbates your throat discomfort, it might be worthwhile to see a gastroenterologist. They can assess for conditions like GERD, which can cause both throat irritation and chest pain. They may recommend tests such as an upper endoscopy or pH monitoring to evaluate acid reflux.

3. Pulmonary Evaluation: If your snoring has increased and you suspect sleep apnea, a pulmonary specialist can conduct a sleep study to determine if you have obstructive sleep apnea, which could be contributing to your symptoms.

4. Rehabilitation and Lifestyle Modifications: In addition to seeking specialist evaluations, consider lifestyle changes that can help alleviate your symptoms. For instance, maintaining a healthy weight, avoiding large meals before bedtime, and elevating the head of your bed can help reduce GERD symptoms. If anxiety is a factor, cognitive-behavioral therapy (CBT) or relaxation techniques may also be beneficial.

5. Follow-Up Care: Regular follow-ups with your primary care physician are essential to monitor your hypertension and any other underlying conditions. They can coordinate care among specialists and ensure that all aspects of your health are being addressed.

In summary, your symptoms warrant a comprehensive evaluation by specialists in ENT, gastroenterology, and possibly pulmonary medicine. By addressing each component of your discomfort, you can work towards a more effective management plan that improves your quality of life.

Please don’t hesitate to reach out if you have further questions or need assistance in navigating these referrals. Your health and well-being are of utmost importance, and I wish you the best in your journey towards recovery.

Best regards,
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