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Incidence of Cardiac Drugs to Cause Pinpoint Odynophagia as a Differentiating Sign of Pills Induced Esophagitis in Patients Presenting with Angina

Kamal Sharma, Consultant Cardiologist, Kamal Sharma Cardiology Clinic, Ahmedabad, Gujarat 380013, , Dhruvkumar M. Patel* , Mukundkumar V. Patel** , Sanjay L. Rajput*** , Kamal Sharma****

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Journal of Cardiovascular Medicine and Surgery 3(2):p 193-197, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.3217.18

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Abstract

Objective: Our aim of present study is to evaluate incidence of pinpoint odynophagia in clinical profile of drug induced oesophagitis (DIO) and its correlation with endoscopic findings particularly kissing ulcer. Materials and Methods: We have studied demographic features, clinical profile and endoscopic findings of cardiac DIO patients from August 2014 to January 2017 at various hospitals of Ahmedabad, India. Overall patients having history of retrosternal chest pain and odynophagia of less than 10 days’ duration preceded by pill ingestion were clinically diagnosed as DIO and were subjected for upper GI endoscopy. All patients were investigated to rule out other causes of chest pain. Patients of infective and corrosive oesophagitis, oesophageal malignancy, chronic liver or kidney diseases and GERD of more than two weeks were excluded from the study. Results: We have studied total 248 patients of DIO and out of these 171 were females. Retrosternal chest pain and odynophagia were present in all patients and pinpoint odynophagia was present in 154 (62.10%) patients, out of them DIO due to cardiac drugs were 22.05%. Upper GI endoscopy showed kissing ulcers at middle third of oesophagus in 74.19% (p value =0.03). History of taking evening pill dose 5-10 minute before going to bed and habit of using less than 100 ml water to swallow pill were present in significant number of patients. Conclusion: Twenty percent of the patients presented with DIO had cardiac drugs responsible for reterosternal chest pain. Pin pointing localised odynophagia is very specific symptom of cardiac DIO and correlate well with kissing ulcer of oesophagus by upper GI endoscopy. Habit of taking evening pill just before retiring to bed and use of less than 100ml water to swallow pill were significant risk factors.

 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.3217.18

Keywords

Cardiac Drug Induced Oesophagitis (DIO); Pin-Point Odynophagia; Upper GI Endoscopy; Kissing Ulcer. 

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