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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
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Eosinophilic Esophagitis with Angina Pectoris.

Min Young Son1, Sung Eun Kim1, Seun Ja Park1

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Summary

Eosinophilic esophagitis (EoE) can mimic cardiac symptoms like chest pain. This case highlights the importance of considering EoE in patients with unexplained chest pain unresponsive to cardiac treatment.

Keywords:
Angina pectorisChest painEosinophilic esophagitisProton pump inhibitors

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Area of Science:

  • Gastroenterology
  • Immunology
  • Cardiology

Background:

  • Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disorder.
  • Dysphagia and food impaction are primary EoE symptoms, but chest pain can also occur.
  • Chest pain is often associated with coronary heart disease, potentially masking other diagnoses.

Observation:

  • A 45-year-old male presented with chest pain, initially diagnosed with angina pectoris.
  • Coronary angiography showed mild left coronary artery stenosis, but symptoms persisted despite treatment.
  • Chest CT revealed esophageal thickening, prompting further investigation.

Findings:

  • Endoscopic examination showed linear furrows and edema.
  • Histology confirmed eosinophilic infiltration (>90 eosinophils/high-power field).
  • The patient was co-diagnosed with asthma and treated with a proton pump inhibitor and fluticasone inhaler.

Implications:

  • This case underscores the diagnostic challenge of EoE presenting as cardiac-like chest pain.
  • Physicians should consider EoE in differential diagnosis for persistent, unexplained chest pain.
  • Prompt diagnosis and treatment of EoE can resolve symptoms and prevent misdiagnosis of cardiac conditions.