SPONTANEOUS PNEUMOTHORAX COMPLICATING CARDIOSPASM

Abstract

Patients suffering from cardiospasm have more or less difficulty in forcing food from the esophagus into the stomach. In the early stages of the disease, dysphagia may be pronounced, and loss of weight and strength results. As the condition progresses, many patients find that by increasing intrathoracic pressure when the esophagus is filled with food they are able to overcome the obstruction at the cardia and force the contents of the esophagus into the stomach. This is accomplished in the following manner : The esophagus is filled with food and the patient assumes an erect posture with the left hand resting on a table or against a wall; the patient swallows several glasses of water in rapid succession and increases intrathoracic pressure by taking a deep inspiration, forcing the chin well downward and forward on the thorax, and then closing the mouth and nasopharynx and making a forced expiratory effort; this