COEXISTENT CORONARY-ARTERY DISEASE AND ESOPHAGEAL SPASM - THE IMPORTANCE OF ESTABLISHING THE SOURCE OF CHEST PAIN

A 55 year old woman presenting with chest pain was found to have significant triple vessel coronary artery disease. Non-invasive investigations showed that she had a good exercise tolerance without inducible ischaemia. The history was more suggestive of an oesophageal source of pain, an impression supported by manometry. This case illustrates some of the problems encountered during the investigation of chest pain and the need to interpret angiographic findings in the context of the patient's functional state.