Not all chest pain is cardiac. The patient above had been experiencing intermittent substernal chest pain with radiation to the back for the past year associated with eating too quickly. They also endorsed a history of heartburn and dysphagia. Scroll down to reveal the diagnosis.
Diffuse Esophageal Spasm
Corkscrew esophagus, or diffuse esophageal spasm, is a relatively rare esophageal motility disorder. Due to minimal available information on the pathogenesis of this occurrence, it is unclear whether this abnormality represents a distinct disorder. The trademark of this form of dysmotility is the presence of excess simultaneous contractions in the distal esophagus, although a number of other motility patterns may be observed. As pictured here, barium radiographic images include severe non-peristaltic contractions which produce abnormalities in the barium column.
To see more cases like this, visit Figure 1. I encourage you to check it out and continue to work on your visual diagnosis skills!