Acute Coronary Syndrome: An Unusual Consequence of GERD

Abstract

We report a case of an 83-year-old man with history of coronary artery disease and gastroesophageal reflux disease (GERD) who presented with sudden onset nocturnal dyspnea. He was diagnosed with non-ST elevation myocardial infarction based on the electrocardiographic changes and cardiac biomarker elevation. Cardiac catheterization revealed chronic three-vessel coronary artery disease, with 2 patent grafts and 2 chronically occluded grafts. While at the hospital, the patient experienced a similar episode of nocturnal dyspnea, prompting a barium esophagram, which was suggestive of a stricture in the distal esophagus from long-standing GERD. We hypothesized that he had myocardial ischemia due to increased oxygen demand from uncontrolled GERD symptoms. He had no further ischemic episodes after increasing the dose of antireflux medication over a 6-month follow-up. After presenting our case, we review the literature on this atypical presentation of GERD causing acute coronary syndrome and discuss potential mechanisms.

A Novel Nomogram for Predicting the Risk of Coronary Atherosclerosis in Patients with Gastroesophageal Reflux Disease A Nomogram Predicting Coronary Atherosclerosis

“…Many patients with GERD combined with CA can be seen in the hospitals. They are at a higher risk of cardiovascular events than patients without CA [11]. There are some previous studies focusing on the relationship between GERD and CA, but the exact link between the two has not been clari ed [7,12,13].…”