[Differential diagnosis in GERD and cardiovascular disease].
In substantial portion of patients referred to the coronary care unit (CCU) with a tentative diagnosis of acute coronary syndrome (ACS), gastro-esophageal diseases are the origins of their symptoms such as chest pain. The differential diagnosis is difficult and the coronary angiography (CAG) and the gastro-esophageal endoscopy are often required. We recently evaluated our 100 consecutive cases that underwent CAG as ACS. Among the 100 cases, 72 had significant organic coronary artery lesions, 5 had significant coronary vasospasms proved by the acetylcholine provocation, and the other 23 showed no detectable major coronary artery abnormality. Among the last 23 cases, gastro-esophageal endoscopy revealed the gastro-esophageal diseases such as reflux esophagitis in 7 cases. Those 7 cases with gastro-esophageal diseases had less coronary risk factors than the 77 cases with the coronary artery diseases. Gastro-esophageal diseases are the major differential diagnoses of ACS, especially in those with few coronary risk factors.
Aoyagi
Teruhiko
T
Department of Cardiovascular Medicine, Japanese Red Cross Medical Center.
D000109:Acetylcholine; D000208:Acute Disease; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004945:Esophagoscopy; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis*; D005773:Gastroscopy; D006801:Humans; D013577:Syndrome
D000109:Acetylcholine