Question: A 74-year-old woman with a history of hypertension presented with a sudden onset of severe pain in the chest, progressive dysphagia, and vomiting. She had no previous history of symptoms related to her upper gastrointestinal tract. Physical examination was unremarkable. Laboratory tests, including cardiac enzymes, were normal. Coagulation profile was normal. An electrocardiogram and a chest radiograph were normal. Computed tomography of the chest and upper abdomen revealed an extensive thickening of the esophageal wall without any evidence of perforation (Figure A, B).