Candy cocaine esophagus

Reversible thermal injury to the esophagus from drinking boiling-hot liquids has been reported to produce alternating pink and white linear bands that impart a "candy-cane" appearance to the inner esophageal wall. This injury has been associated with chest pain, dysphagia, odynophagia, and abdominal pain. We describe a case of candy-cane esophagus caused by thermal injury from smoking freebase cocaine, associated with left shoulder and arm pain, diaphoresis, hypotension, and transient cardiac ischemia. This case illustrates the importance of considering candy cane esophagus in the evaluation of chest pain, even when this symptom is suspected to be of cardiac origin.