Table 1. Differences between esophageal rupture and acute coronary syndrome .

	Esophageal rupture	Acute coronary syndrome
Risk factors	Violent vomiting, retching or esophageal instrumentation	Age, male, diabetes, hypertension, hyperlipidemia and smoking
History	Alcoholism, heavy drinking or gastroduodenal ulcer	Myocardial infarction or coronary artery disease
Classical presentation	Retching and vomiting followed by chest and upper abdominal pain	Chest tightness radiating to left arm and angle of the jaw
Physical examination	Subcutaneous crepitus, asymmetric breath sounds, tachycardia, tachypnea or hypotension	Normal, S4 gallop, tachycardia, tachypnea or hypotension
CXR	Mediastinal air, free peritoneal air or pleural effusion	Normal, pulmonary congestion or pulmonary edema
ECG	Normal or nonspecific T-wave changes	T wave inversion, ST-T changes, or pathological Q wave

CXR, Chest X ray; ECG, Electrocardiogram.