Tortuous aorta--a new cause for esophageal chest pain?

Three patients (average age 61 years) presenting with retrosternal pain were evaluated with barium studies of the upper gastrointestinal tract. In each case, the esophagus was significantly displaced by a tortuous aorta. All patients had sliding hiatal hernias; these hiatal hernias, and the esophagitis and disordered motility seen in our patients, could be a consequence of esophageal displacement by the tortuous aorta. Two patients were relieved symptomatically with antacids and metoclopramide. Thus, tortuosity of the thoracic aorta can cause esophageal chest pain.