If At First You Don't Succeed...

Testing is important in practicing medicine. In principle, we don't like to repeat tests. However, sometimes it is necessary. My experience with the following patient illustrates this principle.

An elderly woman with heart disease was having episodes of moderate to severe chest pain. Several years earlier she had undergone coronary bypass surgery for chest pain, and after the surgery the pain had resolved. Now it was back.

The patient's cardiologist had done the appropriate testing, including coronary angiography, and had concluded that the chest pain was not originating from her heart. Among the diagnoses he considered as a cause of the chest pain was an esophageal motility disorder, or more specifically, esophageal spasm. He asked me to evaluate his patient for this possibility.

Medically Reviewed by a Doctor on 12/9/2014

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