Land mark papers in cardiology : What is the hidden link between esophagus and coronary artery ?

• Gastric pain is a great mimicker of cardiac pain.
• It may have , almost all the typical characters of angina . . . in some cases ECG changes too.
• The confusion is complete ,  as esophageal pain can also  be relieved by sublingual nitrates !
• The issue is further complicated, when  esophagus and coronary artery share  the same neural codecs, and each may induce spasm among themselves !
• It is thought , of course with  some  evidence !  many of the syndrome X  patients ( positive stress test with normal coronary arteries )  have esophageal motility disorders.
• The ST segment depression during EST  in these patients  is apparently attributed to  stress induced esophageal spasm !
• And many of the patients with variant angina  ,  have associated esophageal sapsm .

Read this land mark concept paper  documenting the neural link between esophagus and the coronary artery

Click on the article

Final message

1. Don’t ever forget the esophagus in your scheme of things when evaluating  CAD.
2. Realise  that esophageal disorders  not only cause non cardiac pain but also cause    ischemic chest pain (Also called linked angina)
3. EsophagEal  smooth muscle cell  can  exert electrical influence on the ST segment of  cardiac ECG !(After all every cell

has an action potential )