Can Heart Problems Affect Swallowing?

Understanding Dysphagia in heart conditions

Most people don’t think about swallowing until it becomes difficult. Swallowing, or the medical word deglutition, involves a delicate coordination of muscles, nerves, and organs. But did you know that problems with the heart can sometimes cause swallowing problems too? This is called dysphagia, and although it isn’t common, it’s important to understand because it may signal an underlying heart issue.

How are the heart and swallowing connected?

The oesophagus (the food pipe that carries food and drink to the stomach) sits right behind the heart and the large blood vessels in the chest. Because of this close position, changes in the heart or the aorta (the main blood vessel leaving the heart) can press on or affect the oesophagus.

Here are some ways heart problems can lead to swallowing problems:

• An enlarged heart chamber pressing on the oesophagus.
  When the left atrium (one of the heart’s chambers) becomes very large, it can press against the oesophagus, making it harder for food to pass. Doctors call this “dysphagia megalatriensis.”

• A swollen or twisted aorta.
  If the aorta becomes enlarged (an aneurysm) or bends abnormally with age, it can squeeze the oesophagus. This is sometimes called “dysphagia aortica.”

• Changes in how the oesophagus moves.
  In people with advanced heart failure, the muscles of the oesophagus may not squeeze food as strongly. This can cause food to feel like it’s “sticking.”

• After surgery or scarring.
  Some people may develop swallowing problems after heart surgery or if scarring forms in the chest.

Although these causes are rare, they are well recognised in medical research.

My own grandmother, when she experienced heart failure originally caused by the childhood condition Scarlet Fever, one of her symptoms was difficulty swallowing. At the time it was happening, she was also having trouble breathing due to liquid in her lungs. My grandfather tried to help by getting her to suck peppermints, but that was potentially dangerous and my mother removed him from the room whilst waiting for the paramedics.

What symptoms might you notice?

People with dysphagia linked to the heart often say:

• Food feels stuck.

• They may cough or choke when eating.

• It can feel uncomfortable or painful to swallow.

• Over time, they may lose weight because eating becomes such an effort.
  

If you have heart problems and notice new swallowing difficulties, it’s important not to ignore them.

How your GP might check for the cause

Your GP (family doctor) will usually start with questions and an examination. They’ll want to know when the swallowing problems started, whether they happen with solids, liquids, or both, and if you’ve noticed weight loss or chest pain.

They may then arrange some tests, such as:

• Chest X-ray – to look for an enlarged heart or changes in the aorta.

• Endoscopy (camera test) – to rule out other causes like reflux or cancer.

• Barium swallow – where you drink a contrast liquid and have X-rays to watch food travelling down.

• Echocardiogram (heart scan) or CT scan – if a heart-related cause is suspected, these can show if the heart or aorta is pressing on the oesophagus.

These tests help separate heart-related dysphagia from more common causes like reflux or narrowing in the oesophagus.

What treatments are available?

Treatment depends on what’s causing the swallowing problem. For many people, helping the heart helps the swallowing too.

• Managing heart failure – medicines such as diuretics (to reduce fluid), beta-blockers, or ACE inhibitors may shrink the heart a little and take pressure off the oesophagus.

• Valve problems – if a heart valve (like the mitral valve) is causing the left atrium to enlarge, repairing or replacing the valve can relieve symptoms.

• Aortic aneurysm or twisting – some people may need surgery or a stent procedure to repair the aorta.

Alongside this, you may be referred to a speech and language therapist for swallowing techniques and advice on safer eating. Sometimes, soft diets or pureed food are suggested until the underlying problem is treated. If reflux is also present, your GP may prescribe acid-reducing medicines such as proton pump inhibitors.

Why it’s important to get checked

Dysphagia caused by heart problems is unusual, but it can be a warning sign of something serious like aortic enlargement or worsening heart failure. The good news is that once the heart condition is treated, the swallowing often improves.

Final thoughts

If you or someone you know has both heart problems and new swallowing difficulties, it’s important to speak to your GP promptly. Don’t dismiss swallowing problems as “just getting older.” They may be a clue that the heart or aorta needs attention.