Chest pain with painful swallowing can mean a number of things including heart attack in progress, heart attack in the near future and benign esophageal spasms.

About 200,000 people in the U.S. every year suffer from some kind of non-cardiac chest pain that may be accompanied by other symptoms like discomfort swallowing.

Dr. Ron Schey, a gastroenterologist at Temple University Hospital, recommends a specific treatment for chest pain that results from an issue with the esophagus rather than the heart: dronabinol.

Dronabinol is a drug that historically has been used for nausea and vomiting that result from chemotherapy.

Dr. Schey had a small group of people with non-cardiac chest pain (which can mimic a heart attack and cause severe anxiety) take five mg of dronabinol two times a day for four weeks, while other patients took a placebo.

Those on the dronabinol did better with tolerating their chest pain, and it was less intense and less frequent. Plus, there were no notable side effects.

Because this study was small, it’s not possible to compare how this drug works for non-cardiac chest pain vs. the current therapies.

Dr. Schey explains in his study report that dronabinol likely works by activating cannabinoid receptors in one’s esophagus, thereby reducing sensitivity. A larger-scale study is planned.

If you’ve been experiencing chest pain, even if there is some kind of difficulty or discomfort with swallowing, you should get a thorough evaluation at the ER to rule out a heart attack (a blood test will do this).

However…the blood test (which checks for leakage from damaged cardiac muscle of an enzyme called troponin) does NOT detect the presence or absence of clogged arteries!

“Troponin is a protein in the heart involved with contraction and relaxation of the heart muscle,” says Jack Wolfson, DO, FACC, a practicing cardiologist in Arizona, author of The Paleo Cardiologist: The Natural Way to Heart Health.

He continues: “If troponin is elevated, it is a sign of heart muscle damage. This is obviously not a good thing.

“But millions of people are walking around with extensive blockages, yet troponin is normal if checked.

“Again, elevated troponin is a sign that you may be having a heart attack.”

“Thus, if this blood test comes out negative, you should then follow up with your cardiologist.

“If all is fine, then the next step might be with a gastroenterologist to see if there’s an issue with your esophagus (which could be a spasm or acid reflux, among other issues) that’s causing the chest symptom.”

Wolfson Integrative Cardiology specializes in functional medicine and provides treatment plans for out-of-town patients.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health. 
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