Esophageal spasms are painful contractions within the muscular tube connecting your mouth and stomach (esophagus). Esophageal spasms can feel like sudden, severe chest pain that lasts from a few minutes to hours. Esophageal spasm can be divided into 2 major variants that are distinct entities: diffuse esophageal spasm and hypertensive peristalsis. Diffuse esophageal spasm is characterized by contractions that are of normal amplitude but are uncoordinated, simultaneous, or rapidly propagated. Hypertensive peristalsis, also known as nutcracker esophagus, is diagnosed when contractions proceed in a coordinated manner but the amplitude is excessive.