This is a condition resulting from motility disorders of the esophagus ranging from absent peristalsis to hyperperistalsis and spasm. Diffuse esophageal spasm typically causes substernal chest pain in association with difficulty in swallowing (dysphagia) of both liquids and solids. The pain may be severe and may awaken the patient from sleep. Liquids that are very hot or cold may aggravate the pain. With time, this disorder may evolve into achalasia (failure to relax smooth muscle fibers of the gastrointestinal tract). There may be reflux of recently swallowed food. Combinations of all of these with abnormal lower or upper esophageal sphincter function complete the clinical picture. Esophageal spasm may also produce a severe pain in the absence of dysphagia that is indistinguishable from angina pectoris . This pain is often described as a substernal squeezing pain and may occur in association with exercise. A specific cause is seldom found, but there may be associated reflux esophagitis (i...
Vascular spasms temporary limit blood flow to tissue supplied by that vessel. The most common symptom is pain. Other symptoms are caused by lack of proper circulation and will vary depending on the specific organ affected:
When the spasm affects circulation in a limb, there may be pallor and a sensation of cold in that arm or leg. Limb function and movement will be impaired.
When the spasm affects circulation in the heart, there may be symptoms similar to a heart attack and irregular heartbeats. Other names for chest pain resulting from vascular spasm are Prinzmetal's angina and variant angina.
Signs and tests
These vary depending on the affected organ.
Premature ventricular contractions (PVCs) are early or extra heartbeats that commonly occur and are usually harmless in normal hearts, but can cause problems in hearts with pre-existing disease. Abnormally fast heart rates are classified into two types: supraventricular (meaning "above the ventricle") tachycardias, those that arise in the atria (plural of atrium) or the atrioventricular node, and ventricular tachycardias. In both instances, an extra or early beat may trigger the rapid rhythms. Although the sinus node develops as the specialized site of impulse production, all cardiac muscle cells retain the capacity to become pacemaker cells. Normally, the pacemaking activity of the sinus mode suppresses impulse production by other cells, but if conductance to some other part of the heart muscle is blocked, or if the heart is over stimulated, islands of cells may express their latent impulse-production ability, resulting in extra beats. In other words, impulses are fired from o...
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