BMJ Case Reports 2017; doi:10.1136/bcr-2017-221274
  • Rare disease

Oesophageal ischaemia: an uncommon cause of chest pain

  1. Bashir Rameh1,2
  1. 1Department of Gastroenterology, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Oldham, Manchester, United Kingdom
  2. 2Department of Gastroenterology, Pennine Acute Hospitals NHS Trust, Manchester, UK
  1. Correspondence to Dr Akram Algieder, akramjder{at}, akramjder10{at}
  • Accepted 7 September 2017
  • Published 11 October 2017


A 79-year-old woman with a history of ischaemic heart disease and atrial fibrillation presented to hospital with severe chest pain. Blood tests showed an elevated D-dimer and a rise in troponin I. ECG showed right bundle branch block pattern and T wave inversion in leads V1 to V3, although these changes were present in old ECGs. A chest X-ray was done which was normal. Due to the nature and severity of her pain a CT aortic angiogram was done. This did not show any evidence of aortic dissection or a pulmonary embolism. The patient then had several episodes of haematemesis. An urgent oesophagogastroduodenoscopy was done which showed a circumferential, well demarcated area of blackened oesophageal mucosa. The patient was diagnosed with ischaemic damage to her oesophagus.


  • Contributors AS was the first doctor from the gastroenterology team who came in contact with the patient and had done all initial work and discussion with Consultant gastroenterologist BR. AA then took over from AS regarding continuing care, organising investigations and daily follow-up while the patient in the hospital including liaising with cardiology team and organising repeat endoscopy.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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