Esophageal Spasm Clinical Presentation

Updated: Oct 24, 2017
  • Author: Ahmad Malas, MD; Chief Editor: BS Anand, MD  more...
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Presentation

History and Physical Examination

History

Esophageal spasm usually presents with the following intermittent symptoms:

  • Noncardiac chest pain (<10% of causes of noncardiac chest pain are due to diffuse esophageal spasm; the pain is usually retrosternal, frequently radiates to the back, and can be more severe than angina.)

  • Globus (ie, the sensation that an object is trapped in the throat)

  • Dysphagia, which is more consistent and reproducible during investigative studies, may be reported by one third to two thirds of subjects

  • Regurgitation

  • Heartburn (About 20% of patients report heartburn.)

A correlation between uncoordinated contractions and chest pain can be difficult to document, and, usually, a disparity exists between symptoms and the manometric findings.

Symptoms are usually intermittent and variable from day to day. They may last between minutes and hours.

Pain may be associated with eating quickly or drinking hot, cold, or carbonated beverages.

Anxiety and depression are common in these patients.

Patients with nutcracker esophagus or high-amplitude peristaltic contractions usually present with chest pain, as only 10% experience dysphagia.

Physical examination

Physical examination is typically not helpful for making a diagnosis but may provide clues to a systemic disease if this is the underlying cause of the patient's dysphagia.