Intramural Esophageal Dissection: A Rare Cause of Acute Chest Pain after Percutaneous Coronary Intervention

Abstract

Intramural esophageal dissection is a condition that typically presents with chest pains and may be associated with hematemesis, odynophagia, and hematemesis. The role of antiplatelet/anticoagulant agents in the development of intramural esophageal hematoma is controversial. The management of intramural esophageal dissection is generally conservative with low mortality and morbidity. The case described here is a 66-year-old woman who presented with chest pains, odynophagia, and dysphagia 1 month after percutaneous coronary intervention while taking ASA (80 mg daily) and clopidogrel (75 mg daily) for dual antiplatelet therapy. The patient was diagnosed as intramural esophageal dissection and underwent successful conservative medical management. The relative contribution of dual antiplatelet therapy with ASA and clopidogrel after percutaneous coronary intervention in this case is, albeit uncertain, a possibility.

Unusual Cause of Chest Pain after Percutaneous Coronary Intervention

“…This is followed by dysphagia. Dysphagia is usually reported late in post coronary intervention period as the patients are usually advised to not to take orally in this scenario [4]. Upper GI bleed in the form of hematemesis can occur due to rupture of hematoma.…”

Rare spontaneous extensive annular intramural esophageal dissection with endoscopic treatment: A case report

“…Iatrogenic causes such as the insertion of a nasogastric tube or endoscopic examination, and ingestion of irritating food can also result in IED[ 1 - 3 ]. Patients usually present with dysphagia, odynophagia, and retrosternal chest pain; IED may mimic cardiac or thoracic emergencies, such as acute myocardial infarction and aortic dissection[ 4 , 5 ]. The majority of patients respond well to conservative treatment.…”