questions 2

Diffuse Esophageal Spasm

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Topic updated on 12/05/15 12:24pm

Introduction
  • Strong, non-peristaltic contractions of esophageal body (normal sphincter function)
  • Associated conditions
    • GERD
Presentation
  • Symptoms
    • spontaneous chest pain that radiates to back, ears, neck
      • similar to angina
Evaluation
  • Upper GI barium swallow
    • shows corkscrew esophagus
  • Manometry  
  • Endoscopy
Treatment
  • Medical
    • reflux medications
    • nitrates
    • Ca channel blockers


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(M1.GI.59) A 64-year-old Caucasian male presents to the cardiologist complaining of chest pain. He describes the pain as spontaneous and radiating to his back, ears, and neck. He denies dyspnea on exertion. The patient is referred for an upper GI barium swallow, shown in image A. Which of the following would you most expect to find during further workup of this patient? Topic Review Topic
FIGURES: A          

1. Abnormal electrocardiogram
2. Abnormal coronary angiogram
3. Abnormal esophageal biopsy
4. Abnormal pulmonary function tests
5. Abnormal esophageal manometry

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