A report on Chest pain and Esophageal achalasia

Potential location of pain from a heart attack
A chest X-ray showing achalasia ( arrows point to the outline of the massively dilated esophagus )
A blockage of coronary arteries can lead to a heart attack
Transhiatal oesophagectomy specimen from a patient suffering from late-stage achalasia. Diverticulum at the left lower end of the oesophagus.
Gastroesophageal reflux disease is a common cause of chest pain in adults
An axial CT image showing marked dilatation of the esophagus in a person with achalasia.
"Bird's beak" appearance and "megaesophagus", typical in achalasia.
Schematic of manometry in achalasia showing aperistaltic contractions, increased intraesophageal pressure, and failure of relaxation of the lower esophageal sphincter.
Image of a stomach which has undergone Fundoplomy

Achalasia is characterized by difficulty in swallowing, regurgitation, and sometimes chest pain.

- Esophageal achalasia

Achalasia, nutcracker esophagus, and other motility disorders of the esophagus

- Chest pain
Potential location of pain from a heart attack

3 related topics with Alpha

Overall
Normal peristalsis in time space graph. Nutcracker esophagus shows higher amplitude contractions (Z-axis) that take longer to pass (X-axis)

Nutcracker esophagus

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Disorder of the movement of the esophagus characterized by contractions in the smooth muscle of the esophagus in a normal sequence but at an excessive amplitude or duration.

Disorder of the movement of the esophagus characterized by contractions in the smooth muscle of the esophagus in a normal sequence but at an excessive amplitude or duration.

Normal peristalsis in time space graph. Nutcracker esophagus shows higher amplitude contractions (Z-axis) that take longer to pass (X-axis)
Diagram of esophageal motility study in nutcracker esophagus: The disorder shows peristalsis with high-pressure esophageal contractions exceeding 180 mmHg and contractile waves with a long duration exceeding 6 sec.
Normal esophagus in (A). Nutcracker esophagus in (C): high-pressure waves in blue; cross-sectional areas (CSA) in fucsia.

Nutcracker esophagus is one of several motility disorders of the esophagus, including achalasia and diffuse esophageal spasm.

It causes difficulty swallowing, or dysphagia, to both solid and liquid foods, and can cause significant chest pain; it may also be asymptomatic.

The digestive tract, with the esophagus marked in red

Esophagus

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Organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the stomach.

Organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the stomach.

The digestive tract, with the esophagus marked in red
The esophagus is constricted in three places.
A mass seen during an endoscopy and an ultrasound of the mass conducted during the endoscopy session.

Diseases may cause difficulty swallowing (dysphagia), painful swallowing (odynophagia), chest pain, or cause no symptoms at all.

Achalasia refers to a failure of the lower esophageal sphincter to relax properly, and generally develops later in life.

A drawing of a hiatal hernia

Hiatal hernia

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Type of hernia in which abdominal organs slip through the diaphragm into the middle compartment of the chest.

Type of hernia in which abdominal organs slip through the diaphragm into the middle compartment of the chest.

A drawing of a hiatal hernia
Schematic diagram of different types of hiatus hernia. Green is the esophagus, red is the stomach, purple is the diaphragm, blue is the HIS-angle. A is the normal anatomy, B is a pre-stage, C is a sliding hiatal hernia, and D is a paraesophageal (rolling) type.
A large hiatal hernia on chest X-ray marked by open arrows in contrast to the heart borders marked by closed arrows
This hiatal hernia is mainly identified by an air-fluid level (labeled with arrows).
Upper GI endoscopy depicting hiatal hernia
Upper GI endoscopy in retroflexion showing Type I hiatal hernia
A hiatal hernia as seen on CT
A large hiatal hernia as seen on CT imaging
A large hiatal hernia as seen on CT imaging

Other symptoms may include trouble swallowing and chest pains.

Meanwhile, manometry can determine the integrity of esophageal movements, and the presence of esophageal achalasia.