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Case Reports in Emergency Medicine
Volume 2013, Article ID 646342, 4 pages
Case Report

A Rare Cause for Acute Chest Pain in the Emergency Setting That Is Hard to Swallow

Department of Emergency Medicine, The Ohio State University Medical Center, 750 Prior Hall, 376 W 10th Avenue, Columbus, OH 43210, USA

Received 1 June 2013; Accepted 1 July 2013

Academic Editors: N. Kikuchi and M. Smith

Copyright © 2013 Eric Cummins et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Intramural esophageal hematoma is a very rare but important cause of chest pain. This condition shares similarity with the diagnosis of other thoracic emergencies and has a high potential for misdiagnosis. The emergency clinician plays a critical role in the early identification and management of these patients. The management of intramural hematomas is typically conservative, and a misdiagnosis could lead to deleterious effects. Preexisting coagulopathy is one of the major risk factors. With the advent of new anticoagulation medications to prevent thromboembolic events, it is important that emergency medicine providers expand the differential diagnosis of chest pain.