Pain in the middle of the chest or upper back can result from disorders of the esophagus Overview of the Esophagus The esophagus is the hollow tube that leads from the throat (pharynx) to the stomach. Food does not just fall through the esophagus into the stomach. The walls of the esophagus propel food to... read more or from disorders of the heart or aorta (see Chest Pain Chest Pain Chest pain is a very common complaint. Pain may be sharp or dull, although some people with a chest disorder describe their sensation as discomfort, tightness, pressure, gas, burning, or aching... read more ). Symptoms may be similar. Gastroesophageal reflux disease Gastroesophageal Reflux Disease (GERD) In gastroesophageal reflux disease, stomach contents, including acid and bile, flow backward from the stomach into the esophagus, causing inflammation in the esophagus and pain in the bottom... read more (GERD), caused by stomach acid splashing up into the esophagus, can cause a burning sensation or a tightness under the breastbone (sternum), which may resemble the pain of heart disease. Spasms of the esophagus Esophageal Spasm Esophageal spasm is a disorder of the rhythmic waves of muscular contractions (peristalsis) of the esophagus. The cause of this disorder is not known. Symptoms include chest pain and difficulty... read more and other esophageal muscle disorders can cause a severe squeezing sensation also resembling the pain of heart disease.
Some symptoms are more suggestive of esophageal disorders. Severe pain that occurs suddenly after vomiting or after a procedure involving the esophagus suggests a rupture of the esophagus, although this is rare. Heartburn is a burning pain caused by GERD that rises into the chest and sometimes the neck and throat, usually after meals or when lying down. Heartburn is among the most common digestive symptoms in the United States. Difficulty swallowing Difficulty Swallowing Some people have difficulty swallowing (dysphagia). In dysphagia, foods and/or liquids do not move normally from the throat (pharynx) to the stomach. People feel as though food or liquids become... read more and discomfort that occurs only with swallowing also suggest an esophageal disorder. Chest discomfort that occurs routinely with exertion and goes away after a brief rest suggests a heart problem. However, because symptoms frequently overlap, and because heart disease is particularly dangerous, doctors often do a chest x-ray X-Rays of the Chest Anyone thought to have a heart disorder has chest x-rays taken from the front and the side. Typically, the person is standing upright, but chest x-rays can be done with people lying in bed if... read more , an electrocardiogram Electrocardiography Electrocardiography (ECG) is a quick, simple, painless procedure in which the heart’s electrical impulses are amplified and recorded. This record, the electrocardiogram (also known as an ECG)... read more (ECG), and sometimes a cardiac stress test Stress Testing Stressing the heart (by exercise or by use of stimulant drugs to make the heart beat faster and more forcibly) can help identify coronary artery disease. In coronary artery disease, blood flow... read more before doing tests to look for esophageal disease.