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.

Keywords: Chest pain; Dissection; Esophagus; Percutaneous coronary intervention.

Figure 1

Computed tomography angiography, showing a large mass-like area along the posterior aspect of the thoracic esophagus (arrow)

Figure 2

Computed tomography angiography, showing a large mass-like area along the posterior aspect of the thoracic esophagus (arrow)