Esophageal dysmotility and acid sensitivity in patients with mitral valve prolapse and chest pain.
Mitral valve prolapse (MVP) patients often experience non-cardiac chest pain. The aims of this study were to determine, in patients with non-cardiac chest pain: (i) whether esophageal dysmotility is more common in patients with MVP than in patients without MVP; and (ii) if acid sensitivity is an important cause of the chest pain in MVP patients. Esophageal manometry and acid perfusion testing were performed in 277 consecutive patients with non-cardiac chest pain. Patients with MVP (13 female, one male; mean age 49 years) were more likely (P = 0.01) to have esophageal dysmotility, while acid perfusion was less likely (P < 0.05) to provoke their chest pain, than in patients without MVP. The most common esophageal motor abnormalities detected in patients with and without MVP were diffuse esophageal spasm (prevalence, 57%) and non-specific motor disorder (prevalence, 9%), respectively. This study, the first large prospective series examining possible esophageal sensorimotor correlates of chest pain in MVP patients, demonstrates that in the absence of a cardiac cause for chest pain, a specific esophageal motility disorder should be excluded, rather than assuming the chest pain is likely to be due to acid sensitivity.
Hammett
R J H
RJ
Department of Gastroenterology and Gastrointestinal Investigation Unit, Royal North Shore Hospital, St. Leonards, NSW, Australia.
Hansen
R D
RD
Lorang
M
M
Bak
Y T
YT
Kellow
J E
JE
D002637:Chest Pain / Q000209:etiology*; D015154:Esophageal Motility Disorders / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005744:Gastric Acid; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D011446:Prospective Studies