Cardiac spasm, also known as Achalasia, is a rare disease of the esophagus, ranked second after esophageal cancer. The overall frequency is 6 cases/100,000 population/year.

In this review, the epidemiology, pathophysiology, and presentation of most common esophageal motility disorders (EMD) will be covered. Achalasia is the best described disorder in the group and its features will be highlighted. As diagnostic and therapeutic options for esophageal motility disorders are increasing, a multimodal approach is required and referral to gastroenterology or surgery is recommended for further management of these disorders.

Therapy for esophageal motility disorders initially focuses on the condition of the pressure in the lower esophageal sphincter. If the pressure is elevated, medical or surgical treatment is needed to reduce the pressure. In spastic motor disorders (jackhammer esophagus, type III achalasia, esophageal spasm), treatment may also focus on relaxing the esophageal muscle.