Esophageal Reflux and Variant Angina Pectoris

A patient was hospitalized because of retrosternal pain that was unrelated to effort and recurred in the early morning hours. An esophageal diverticulum and a hiatal hernia were found. The patient had complaints despite medical therapy and was operated on. After operation, the patient had the same pain. A cardiologist was consulted, who suggested Prinzmetal variant angina. During arteriography, coronary artery disease was found. Revascularization was indicated and performed; after that the patient has remained free of any complaints. This observation reaffirmed Prinzmetal's original statement that: “The key to the diagnosis … is the taking of a painstaking history.” A patient was hospitalized because of retrosternal pain that was unrelated to effort and recurred in the early morning hours. An esophageal diverticulum and a hiatal hernia were found. The patient had complaints despite medical therapy and was operated on. After operation, the patient had the same pain. A cardiologist was consulted, who suggested Prinzmetal variant angina. During arteriography, coronary artery disease was found. Revascularization was indicated and performed; after that the patient has remained free of any complaints. This observation reaffirmed Prinzmetal's original statement that: “The key to the diagnosis … is the taking of a painstaking history.”