Esophageal spasm

Background

• Strong spasms of the musculature of the esophagus that can last minutes to hours and mimic the chest pain of angina

Clinical Features

• Squeezing or tightening pain in the chest
• Can have associated dysphagia +/- globus sensation

Evaluation

• Unclear what causes esophageal spasm. Possibly related to food intolerance. Can be triggered by eating hot or cold drinks/food.

Workup

• Esophageal spasm is a diagnosis of exclusion. Work-up should focus on ruling out more serious etiologies.
  • ECG
  • CBC
  • Chemistry
  • Troponin
  • CXR
• Consider:
  • BNP
  • PT/PTT
  • D-dimer vs. CTA chest