Which of the following statement(s) is/are correct concerning the patient whose barium esophogram is shown below?

a.The patient’s complaint would be primarily chest pain and to a lesser degree dysphagia

b.The pathognomic feature of manometry is the presence of prolonged high amplitude waves

The barium esophogram of these two patients shows diffuse esophageal spasm resulting in a cork screw esophagus with multiple contractions. See Fig. 18-35. These primary motor disorders are characterized by substernal chest pain. In the nutcracker variety, as demonstrated in this x-ray, the pain is central crushing pain with no relation to food ingestion and differs from angina in that it more frequently comes on at rest. Dysphagia or classic heartburn may be present but tend to be overshadowed by the chest pain. Barium radiography and endoscopy are generally not helpful. The pathognomic feature of manometry is the presence of prolonged high amplitude waves, with a peak greater than 180 mm Hg. Diffuse esophageal spasm and nutcracker esophagus are benign conditions which rarely cause nutritional problems and do not lead to lifethreatening complications. For this reason, symptom control is the only significant goal of treatment. Medical treatment for diffuse esophageal spasm and nutcracker esophagus is focused on abolishing strong simultaneous contractions and generally employs calcium channel blocking agents or long-acting nitrates. Surgery for these conditions are generally only considered when medical treatment is ineffective.