[Angina-like chest pain and exertional esophageal ph monitoring].
OBJECTIVE
Spontaneous chest pain attacks are uncommon during 24-hour esophageal pH monitoring in patients suffering from angina-like chest pain suspected to be acid-related. The aim of this study was to assess the diagnostic value of exertional esophageal pH monitoring and to prove that exercise testing induces chest pain and gastro-esophageal reflux and therefore improves symptomatic correlation study.


METHODS
Forty three patients suffering from angina-like chest pain underwent treadmill exercise testing during a 24-hour esophageal pH monitoring. Symptom analysis was made using the symptom-association probability described by Weusten.


RESULTS
During the 24-hour pH monitoring, 10 patients (23%) had a pathologic esophageal acid exposure, 20 (46%) experienced chest pain and 3 (7%) had a symptom association probability > 95%. During the exercise testing on a treadmill, 19 patients (44%) had gastro-esophageal reflux, and 14 (32%) experienced chest pain, coinciding with a gastro-esophageal reflux in 8 (19%). After exercise testing, the symptom-association probability analysis was significantly changed in 9 patients (21%), > 95% in 6 patients (14%).


CONCLUSIONS
Exercise testing on a treadmill induces chest pain episodes during a 24-hour esophageal pH monitoring and therefore improves symptomatic correlation study in patients suffering from angina-like chest pain.
Romand
F
F
Service d'Hépato-Gastroentérologie, HIA Desgenettes, Lyon.
Vincent
E
E
Potier
V
V
Claudel
N
N
Galoo
E
E
Desbaumes
J
J
D000328:Adult; D000368:Aged; D000787:Angina Pectoris; D002637:Chest Pain; D003937:Diagnosis, Differential; D004947:Esophagus / Q000378:metabolism*; D015444:Exercise; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged
Douleurs thoraciques pseudo-angineuses et pH-métrie oesophagienne d'effort.