[A comparative prospective study of an edrophonium test and an esophageal balloon distension test in 78 patients with non-coronary angina and 12 healthy controls].
The aim of this study was to compare the most current tests used for the diagnosis of esophageal angina-like pain: manometry, balloon distension, edrophonium provocation.


METHODS
78 patients with angina-like pain, who had normal coronary arteriograms, and 12 healthy controls were prospectively evaluated with esophageal manometry, esophageal balloon distension, according to Barish's method (2), edrophonium provocation and 3 h pH-monitoring. Provocation tests were considered positive if they reproduced the angina-like pain.


RESULTS
basal manometry was abnormal in 23 patients (29%); nutcracker esophagus; 8, achalasia; 1, diffuse esophageal spasm: 1, hypertensive LES: 2, non specific motility disorders: 5, It was abnormal in 1 healthy control (1 nutcracker esophagus). Edrophonium provocation was positive in 19 patients (24%) and in none of the controls. Balloon distension was positive in 33 patients (42%) and none of the controls, but 3 controls experienced a back pain at 7, 9 and 9 cc. Balloon distension was more sensitive than edrophonium provocation (p less than 0.001). There was no correlation between the results of the basal manometry and those of balloon distension and no correlation between pH monitoring and balloon distension. 1) Balloon distension is the most sensitive test and should be used at first. 2) If balloon distension is negative edrophonium provocation can be useful because the pain mechanism is different. 3) Some controls can experience a back pain without irradiation, then balloon distension must be considered positive only if it strictly reproduces the spontaneous angina-like pain.
Goudot-Pernot
C
C
Service d'Hépato-gastroentérologie, CHU de Nancy-Brabois, Vandoeuvre-lès-Nancy.
Champigneulle
B
B
Bigard
M A
MA
Pernot
C
C
Gaucher
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D002637:Chest Pain / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004491:Edrophonium; D016145:Endoscopy, Digestive System; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis / Q000187:drug effects; D011312:Pressure; D011446:Prospective Studies
D004491:Edrophonium
Etude prospective comparative du test à l'édrophonium et du test de distension oesophagienne par ballonnet chez 78 malades angineux non coronariens et 12 témoins sains.