Abnormal gastro-oesophageal reflux in Chinese with atypical chest pain.
Although atypical chest pain has been well described in the Western population, its frequency in Chinese is unknown. Over a period of 42 months, we studied 521 Chinese patients with chest pain and identified 108 patients (20.7%) whose pain was not related to cardiac causes, as determined by exercise ECG or cardiac catheterization. Using 24 h ambulatory pH monitoring and baseline oesophageal manometry, 28.7, 19.4 and 5.6% of these patients were found to have abnormal reflux parameters, abnormal manometric findings or both, respectively. There were significantly more patients complaining of chest pain during the study in the gastro-oesophageal reflux disease (GERD) group than in the non-GERD group (16/31 vs 20/77; P < 0.001). The lower oesophageal sphincter pressure was lower in those with abnormal reflex parameters than in those with normal reflux parameters (12.7 +/- 5.4 vs 17.8 +/- 5.8 mmHg; P < 0.05). There was no significant difference in symptoms, such as heartburn (54.8 vs 42.9%), regurgitation (38.7 vs 35.1%) and dysphagia (19.4 vs 24.7%), among the two groups. Non-specific changes were the most frequent baseline motility pattern. In conclusion, atypical chest pain and gastro-oesophageal reflux disease are not uncommon in Chinese and this deserves special emphasis as the continuation of anti-anginal drugs may aggravate their condition.
Lau
G K
GK
Division of Gastroenterology and Hepatology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Hui
W M
WM
Lau
C P
CP
Hu
W H
WH
Lai
K C
KC
Lam
S K
SK
D000293:Adolescent; D000328:Adult; D002637:Chest Pain / Q000209:etiology*; D003680:Deglutition Disorders / Q000209:etiology; D015154:Esophageal Motility Disorders / Q000150:complications / Q000503:physiopathology; D004943:Esophagogastric Junction / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000503:physiopathology; D006356:Heartburn / Q000209:etiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011312:Pressure