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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
BMJ Case Rep. 2010; 2010: bcr0520091870.
Published online Dec 2, 2010. doi:  10.1136/bcr.05.2009.1870
PMCID: PMC3029070
Unusual association of diseases/symptoms
10p for an angiogram: the cardio-oesophageal reflex
S R Kandan, D X Augustine, R J Mansfield, and J Easaw
Department of Cardiology, Royal United Hospital, Bath, UK
Correspondence to S R Kandan, raveenkandan/at/
A 57-year-old man presented at our institution with central chest pain. Serial ECGs showed dynamic T-wave changes, suggesting the possibility of unstable angina. Urgent coronary angiography revealed an unexpected finding of a radio-opaque lesion seen in the xiphisternal region during screening. Oesophogastroduodenoscopy confirmed this to be a 10p coin. The coin passed through the gastrointestinal tract without complications and the patient's symptoms and ECG changes resolved. This unusual case is a reminder that many diseases may electrocardiographically imitate an acute coronary syndrome.
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