Electrocardiographic Changes Suggestive of Cardiac Ischemia in a Patient With Esophageal Food Impaction

Abstract

MANY patients presenting with chest pain initially believed to be cardiac in etiology may, in fact, have esophageal disease as an alternative or additional cause of their complaints. Although electrocardiographic (ECG) repolarization abnormalities have been well described in gastroenterologic processes, such as pancreatitis and cholecystitis,¹and have been reported in esophageal disease,^2-9the ECG is generally thought to be a reliable means of distinguishing between esophageal and cardiac pain.^10,11In this report, we describe a patient who developed ECG changes suggestive of cardiac ischemia secondary to esophageal food impaction. <h3>Report of a Case</h3> A 57-year-old woman was admitted to the George Washington University Medical Center, Washington, DC, with a chief complaint of chest discomfort and dysphagia. She had a history of intermittent epigastric and substernal burning discomfort with meals, alleviated by antacids, and in 1979 was found to have a hiatal hernia with reflux by upper gastrointestinal