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[Spontaneous precordial pain: coronary spasm or esophageal pathology?]
Schweizerische Medizinische Wochenschrift
|February 22, 1986
Insights
Chest pain can stem from esophageal issues or variant angina, making diagnosis challenging. Esophageal tests are best done after coronary arteriography to differentiate these conditions.
Area of Science:
- Cardiology
- Gastroenterology
Background:
- Chest pain is a common symptom with overlapping causes.
- Differentiating esophageal spasm/esophagitis from variant angina is clinically significant.
Observation:
- Esophageal spasm or esophagitis can present with chest pain mimicking variant angina.
- Dysphagia or chest pain from iced drinks may indicate coronary spasm, not solely esophageal spasm.
- Three illustrative cases highlight diagnostic challenges.
Findings:
- Differential diagnosis between esophageal and cardiac causes of chest pain requires careful evaluation.
- Coronary arteriography is recommended before esophageal investigations.
- Non-specific symptoms like pain from iced drinks can be misleading.
Implications:
- Accurate diagnosis is crucial for appropriate patient management and treatment.
- Understanding overlapping symptoms aids clinicians in diagnostic pathways.
- Further research may refine diagnostic criteria for chest pain of uncertain origin.
Abstract:
Chest pain due to esophageal spasm or esophagitis may mimic pain of variant angina. Differential diagnosis of the two diseases is often difficult and requires various tests, the value of which is discussed. These problems are illustrated by three cases. The esophageal investigation should preferably be preceded by coronary arteriography. Chest pain or dysphagia due to iced drinks is not specific for esophageal spasm but may be due to coronary spasm.