Snapshot A 49-year-old woman with depression and anxiety presents to the emergency room for chest pain. She reports that she was feeling well apart from intermittent difficulty swallowing. After her smoothie today, she experienced acute onset of retrosternal chest pain that radiated to her neck. She is worried that she is having a heart attack. Introduction Clinical definition login to view 1 more bullet Associated conditions login to view 3 more bullets Epidemiology Incidence login to view 1 more bullet Demographs login to view 2 more bullets etiology Pathogenesis login to view 3 more bullets Presentation Symptoms login to view 3 more bullets Physical exam login to view 1 more bullet imaging Upper gastrointestinal barium swallow login to view 2 more bullets Studies Diagnostic testing login to view 8 more bullets Differential Achalasia login to view 2 more bullets Nutcracker esophagus login to view 2 more bullets Angina and acute coronary syndrome login to view 4 more bullets Treatment First-line login to view 6 more bullets Interventional login to view 3 more bullets Complications Lack of response to treatment