GERD case

Question 1

What are the risk factors associated with GERD and why

What are the signs and symptoms

Answer 1

NSAID use

• COX inhibitor => decrease in PGE2 which is gastroprotective
• increases risk of gastric irritation and GERD

Spicy food and antacids

Central epigastric burning pain after eating
May radiate to throat

Question 2

What investigations would you order and why

What might you find

Answer 2

ECG
-normal, rule out other acute causes

CXR
-normal, rule out other acute causes

TnT
-normal, rule out other acute causes

Question 3

What happens if you misdiagnose this as a MI

What else could this be?

Answer 3

High dose anti platelets, thrombolytics => trigger life threatening upper GI bleed

Cholecystitis, characterised by burning pain exacerbated by food