title: Acute Coronary Syndrome: An Unusual Consequence of GERD.
abstract: We report a case of an 83-year-old man with history of coronary artery disease and gastroesophageal reflux disease (GERD) who presented with sudden onset nocturnal dyspnea. He was diagnosed with non-ST elevation myocardial infarction based on the electrocardiographic changes and cardiac biomarker elevation. Cardiac catheterization revealed chronic three-vessel coronary artery disease, with 2 patent grafts and 2 chronically occluded grafts. While at the hospital, the patient experienced a similar episode of nocturnal dyspnea, prompting a barium esophagram, which was suggestive of a stricture in the distal esophagus from long-standing GERD. We hypothesized that he had myocardial ischemia due to increased oxygen demand from uncontrolled GERD symptoms. He had no further ischemic episodes after increasing the dose of antireflux medication over a 6-month follow-up. After presenting our case, we review the literature on this atypical presentation of GERD causing acute coronary syndrome and discuss potential mechanisms.
authors.affiliation: Department of Medicine, Albany Medical Center, Albany, NY 12208, USA.
authors.forename: Chui Man Carmen
authors.initials: CM
authors.lastname: Hui
authors.affiliation: Department of Medicine, Division of Cardiology, Albany Medical Center, Albany, NY 12208, USA.
authors.forename: Santosh K
authors.initials: SK
authors.lastname: Padala
authors.affiliation: Albany Medical College, Albany, NY 12208, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lavelle
authors.affiliation: Department of Medicine, Division of Cardiology, Albany Medical Center, Albany, NY 12208, USA.
authors.forename: Mikhail T
authors.initials: MT
authors.lastname: Torosoff
authors.affiliation: Department of Medicine, Division of Gastroenterology, Albany Medical Center, Albany, NY 12208, USA.
authors.forename: Xinjun Cindy
authors.initials: XC
authors.lastname: Zhu
authors.affiliation: Department of Medicine, Division of Cardiology, Albany Medical Center, Albany, NY 12208, USA.
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Sidhu