Nitroglycerin and esophageal spasm

Common Questions and Answers about Nitroglycerin and esophageal spasm

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I was just diagnosed with esophageal spasm. I have terrible chest and back pain that comes pretty close to the open-heart surgery I've had in the past. It came on really quickly and the doctor has me on Prilosec and antacids after meals and at bedtime, and she just added viscous lidocaine solution to numb the esophagus. I'm eating a low acidic diet and combining my foods properly. Has anyone out there had this terrible thing and if so, any other suggestions?
Yes, mj, there is esophageal spasm. This term refers to simultaneous contractions of esophageal muscle at several different levels so that the normal movement of food down the esophagus is impaired. Symptoms can include chest pain (may simulate a heart attack) and difficulty swallowing solids and liquids (sensation of food sticking in esophagus). Symptoms can be precipitated by drinking thermally hot or cold liquids e.g. coffee or ice tea. Stress can also precipitate symptoms.
Apparently the ice freezes the muscle that is constricted and it relaxes eventually and eases the pain and with no side effects. The next day though my chest feels sore inside and I usually take only soups. Sometimes it hits me two or three nights in a row. This brings a terrible fear of night approaching and not knowing what to expect. And that I think compounds the issue. I have had H.Pylori and have been treated for it and it cleared up.
For the spasms themselves, the drug of choice is an anti-spasm med. These meds can include drugs such as bentyl, nitroglycerin and certain specific calcium channel blockers. Librax is typically not suggested for either contdition as it can result in relaxation of the lower esophageal sphincter and an increase in reflux into the esophagus. Many drugs affect the LES and they should be avoided.
One month and thousands of $$$ later, he was confident that my heart was fine and that the cause was a hernia and esophageal spasms. And that was it. I was left to deal with them on my own. Very frustrating!! I have tried to alter my diet,I avoid laying down after eating, sleep on 3 pillows, take stomach medications, avoid citric acids and fruits, etc.
I had an episode the other day; an esophageal spasm that triggered a brief heart palpitation. I was overheated and doing strenuous cardio exercise. I accidentally chugged down a big gulp of ice water and slush... you guessed it; I thought I was having a heart attack. It only lasted about 10 seconds, but to put it mildly, It was not fun. A trip to the ER confirmed my heart was OK, and one of the docs suggested an esophagel spasm. I was hopeful, but not totally convinced.
My current complaint is pain and spasm about 1 inch below the sternum which when it becomes severe will radiate up to my jaw and to my back.( No cardiac Problems!!) These spasms are short lived - 2-3 minutes but leaves me with a "real tight feelingof pressure " in the solar plexus area. I also notice less gurgling somach sounds after an episode, like everything is uptight. I find myself trying to burp to relieve the pressure and it only helps a little.
Hi Al, I was searching through some of the archives regarding angina vs. esophageal spasm and noticed that your posts have been removed. I found that to be highly annoying as I and many others on this forum truly value and appreciate your insight. Why would they delete your posts? I thought it strange. Anyhow, hope you're doing well and managing your angina bouts! Take care!
I get a sore throat (not tonsils but when you swallow) I now go straight on antibiotics and use Bricanyl inhaler although it doesnt seem to have much effect except to cause alot of mucus coughed up from the lungs. It causes me to have spasm coughing and if I cannot control this to 3 or 4 coughs my windpipe closes over making it hard to breath in or out. The last one about 2 years ago stopped me breathing in and out completely for 10 to 15 seconds and I thought I had bought it.
They still occur from time to time - and you must remember that they are progressive. Once you have kicked a spasm off it will occur intermittently for a bit until things calm down. I think the spasms are a chronic problem (like the reflux that caused them for me), but the pain and bother can be minimised. I have had many days of complete relief by adopting this approach. I hope this helps.
I don't know if it cured my chest pain or I just forgot about it because my head hurt so bad ;) No, seriously though, it did work (I was having an esophageal spasm). I asked the exact same question in the ER that night, wondering if taking the pill had caused something to go wrong in my head (I was shocked how bad it hurt, and I've got some decent tolerance). The nurse assured me it was causing no harm to my head or brain.
It could be esophageal spasms causing the chest/shoulder pain, and that can be the result of GERD. The only way to change esophageal spasms is to get the GERD under control. But you might want to talk to your doc about using some anti-spasm meds or nitroglycerin - can help if it is esophageal spasms.
I had a heart attack in june of 99 and a second cath three weeks later for heart muscle spasm i am still having spasm and my daily life activities are limited is it always going to be like this from now on ? going through my records I have found all this information but I do need it translated as my cardiologist has not really had the time to explain everything to me....
There are noncardiac causes of chest pain such as acid reflux, esophageal spasm, asthma, other pulmonary conditions and chest wall pain. It is probably worth assuming that your doctors ruled out any life threatening conditions. At this point, you should probably ask your doctors about some of those things i mentioned.
While chest pain that gets better with nitroglycerin can be suggestive of agina, there are several other types of chest pain, such esophageal spasm, that can get better after nitroglycerin. Exercise tests and stress echocardiograms are screening test for coronary artery disease. If these screening tests are abnormal, the next step is most likely a cardiac catheterization and angiogram in order to look definitively at your coronary arteries.
I then had a motility test of my esophagus on 2/10 and I was diagnosed with nutcracker esophagus and given nitroglycerin which relieves my middle chest pain. But, on 2/9, the day before my motility test, I awoke to severe right chest pain which then radiated to my right shoulder blade. I told my doctor before the motility test and he didn't seem to want to hear it, he just wanted to get the test done.
Nitro can help some forms of esophageal spasm. Nitroglycerin is used with esophageal spasms (GERD). It is the one non heart related illness that nitroglycerin works in. However, that doesn't rule out a concomitant heart condition. Nitroglycerin is a vasodilator not only for your heart vessels but for the vascular system which then subsquently lowers your blood pressure. It even dilates the vessels in the brain which then usually gives the side effect of the headache also.
I just found this while looking for some information for my GI appt. tomorrow and can't believe I didn't see this months ago although I had found another vague reference a while ago .... this ties in with the swallowing thread we have going but this is so important (to me!) and exciting (to me!) I had to post it separately. This is my for-real eureka moment. It comes from emedicine.com/MED/topic743.htm "Esophageal spasm can modify cardiac function and vice versa.
If the problem is acid reflux (since you've taken Prilosec), have you discussed the use of specific anti-spasm meds such as bentyl with your doctor? Or the use of nitroglycerin or other calcium channel blockers which are suggested to help with esophageal spasms?
Yes have had all the tests done and the only thing they came up with was esophagus was spasming , wich coarses me to bring water and food up, dosn't happen every time as the spasm will let go and my food will then go down, there is no narrowing at all. The Gastro Specialist says if this widening dosn't work they will try Botex injections into the muscle, I was just hoping that there could be another alternative as these sound a bit servere, Thanks for your help.
I went to my primary care Doctor and his bottom line is that I'm having Esophageal Spasms so he gave me nitroglycerin and told me to go to my Gastro doctor and take mylanta. I went to my Gastro Doc which agreed with my Primary Doctor so I was put on a med and told sorry there's no cure, but try not to be so stressed because that's a known trigger. Let me just say.. I am not anymore stressed then anyone else on a good day.
Nitroglycerin can also relieve esophageal spasm, it's not reliable for differential diagnosis of cardiac vs GI origin for chest pain. I've been through this recently myself and don't have any answers either. Nitro (sublingual) sometimes helped and sometimes didn't. Then on Friday I had a stress echo, my second in six months, again definitely negative. I'm also on Prevacid so my cardiologist doesn't think it's GI related but he also doesn't think it's cardiac. Be careful with nitro.
I experience esophageal spasm and shortness of breath as my primary symptoms, so I suspected my heart. I went into the ER and was given a nitro for the pain after a GI cocktail did nothing. Bingo, it worked. Long story of icky tests aside, it turned out I was having esophageal spasm. The nitro works on it really well, nevermind that horrid headache...I think I forgot any other pain, lol. The experience was scary because I also believed nitro only helped cardiac pain.
I'm 34 yr old male and have been experiencing various chest and left arm pains for about three months. I've seen a plethora of doctors from cardiologist to internist to GI doc to psychologist. Heart problems have been ruled out by numerous EKG's and stress echo test. GI doc found I have a hiatal hernia/GERD from upper GI and is currently being treated with Nexium. Have also had ultrasound of liver/gall bladder and MRI of abdomen - all normal.
There are many causes for this, including an esophageal obstruction (esophageal cancer, esophageal ring, peptic stricture) or motility disorder (i.e. esophageal spasm, scleroderma, achalasia). Motility disorders may have an association with stress. The first test I would suggest would be a barium swallow to determine if there is any deficit in the swallowing mechanism. Depending on what is found, your physician may then opt for an upper endoscopy for further evaluation.
Other types of medications have been used to relieve the pain of esophageal spasm with variable results. Those include nitroglycerin and nifedipidine (Procardia). Obviously, the medications should be complemented by anti-reflux measures. Anti-reflux measures are lifestyle and dietary modifications, which are important in the management of gastroesophageal reflux. You can ask your doctor for a list of these.
They gave me a nitroglycerin patch last night, and this morning they gave me a shot in the belly of some kind medication to prevent blood clots. Early this morning, a nurse told me my cardiac enzyme levels were normal. I spoke to the doctor and left the hospital against medical advice because I could no longer tolerate the claustrophobia, and because they shrugged it off when I told them I'd awakened with a feeling like a gorilla sitting on my chest.
I know this is going to sound crazy...Do you know what an esophageal spasm is? The next time this happens, try drinking (I mean chugging!) a glass of ice water...If it stops it, it's "diagnostic", the theory being the spasm is "shocked" into stopping...Nitroglycerin sometimes works on it too...I'm in agreement with medchick.
Chest wise i'm in the negative digits lol not much muscle there either, It felt like i'd been thumped and unlike what it feels like when my intercostal muscles spasm. Anyhoo, could it be pectoral muscle? "Bottom line, though - don't ignore the heart if you think it is possible. Remember to listen to your instinct!" I totally second that! Cheers.............
I've had lots of weird feelings in my throat and esophagus. I get painful esophageal spasms where I can feel the esophagus spasming up. Sometimes GERD causes weird symptoms like this. I've been taking Nexium, which cuts down on these spasms. Plus, I will go through periods of time (thankful I haven't had this problem in months) where my throat feels like is is spasming up. It's much like having severe anxiety or being upset--the back of the throat is closed up.
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