title: [Atypical chest pain: study by the hydrochloric acid provocation test].
abstract: Evaluation by means of gastroenterological and cardiological methods. The purpose of this paper was to study the origin of chest pain (CP) in patients with normal and pathological coronary arteries as characterized by coronary arteriogram (CA). Sixteen normal control individuals (X 27 years -7 females and 9 males) were studied by means of esophageal manometry (EM) with a 3 way catheter perfused by a low compliance capillary system. Twenty-one patients with chest pain were studied and divided according to coronary arteriogram in normal (NC) and pathological arteries (PC). They were simultaneously studied by means of EM, heart rate/pressure product (RPP), and 12 lead ECG monitoring. After a basal period they were given a Bernstein's provocative chest pain test, and after each of its stages we determined in a simultaneous fashion CP, EM, ECG and RPP. In 61.9% of the patients abnormal basal EM was found. It was characterized by increase in HPZ, duration, propagation velocity and pressure of the peristaltic waves: as well as an increase in the percentage of aperistaltic waves. In 14.2% of the patients the Hydrochloric provocative test was positive. The only statistically significant datum was the heart rate/RPP relationship. We conclude that in future studies it would be of interest to combine 24 hour monitoring EM and pH as well as a more sensitive provocation test such as edrophonium chloride.
authors.affiliation: Servicio de Gastroenterología, Hospital Nacional Profesor Alejandro Posadas, Provincia de Buenos Aires, Argentina.
authors.forename: B
authors.initials: B
authors.lastname: Salis Graciela
authors.forename: J C
authors.initials: JC
authors.lastname: Chiocca
authors.forename: J
authors.initials: J
authors.lastname: Marcarián
authors.forename: A E
authors.initials: AE
authors.lastname: Balestrini
authors.forename: R
authors.initials: R
authors.lastname: Feldman
authors.forename: P A
authors.initials: PA
authors.lastname: Mazure
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002637:Chest Pain / Q000209:etiology*; D004562:Electrocardiography; D015154:Esophageal Motility Disorders / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D006339:Heart Rate; D006801:Humans; D006851:Hydrochloric Acid; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011312:Pressure
chemical_list: D006851:Hydrochloric Acid
vernacular_title: Dolor torácico atípico: estudio mediante la prueba de provocación del ácido clorhídrico.