Odynophagia in a woman with known coronary artery disease - and ischemia on electrocardiogram

Esophageal intramural hematoma can mimic other causes of chest pain. When t he patient is known to have coronary artery disease, the diagnosis may be d ifficult. Moreover, the course may be complicated and may harm the patient if antiplatelet drugs, thrombolytics, and anticoagulants are used. The pres ence of odynophagia should alert the clinician to the possibility of an eso phageal origin, even in a patient with known coronary artery disease. We pr esent a case in which early recognition of the clinical presentation preven ted potential iatrogenic complications.