title: [Usefulness of the combination of the dynamic electrocardiogram with esophageal pH measurement in the differential diagnosis of chest pain].
abstract: Several diseases of the gastrointestinal tract can cause angina-like chest pain. Differential diagnosis can be extremely difficult, especially when pathological gastroesophageal reflux is present. We present 10 cases, 2 males and 8 females, in which invasive and non invasive cardiological techniques were unable to indicate a clear diagnosis. We have therefore used a new technique which combines dynamic electrocardiography with 24 hours monitoring of esophageal pH, to correlate pain symptom with electrocardiographic changes and/or gastroesophageal reflux. Using this approach we have diagnosed the presence of isolated pathological gastroesophageal reflux in 3 patients, isolated ischemic heart disease in 2 cases, both conditions in 3 patients and no signs of either condition in the remaining 2 cases. We think that this technique is of special value in subjects suffering from both conditions (ischemic heart disease and gastroesophageal reflux). It provides objective documentation of the role of each disease in the genesis of pain which is essential in developing appropriate therapy.
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D013909:Thorax
vernacular_title: Utilità dell'associazione elettrocardiogramma dinamico-pH esofagometria nella diagnostica differenziale del dolore toracicó.