Image Diagnosis: Esophageal Intramural Hematoma in Sudden-Onset Chest Pain and Dysphagia

A 72-year-old man presented with sudden-onset chest pain with odynophagia and hematemesis that developed when he was having a meal at a restaurant. His history was significant for coronary artery disease (inferior wall myocardial infarction) and diabetes mellitus, and he was on aspirin, atorvastatin, and metformin. On examination, the patient was in pain and had tachycardia (110 beats/min) and his blood pressure was 100/60 mmHg. The other vitals were normal. The abdominal examination and cardiovascular examination were otherwise unremarkable. Liver function test, renal function test, and the coagulation profile were normal, as were the electrocardiogram, cardiac enzymes, and chest roentgenogram