Noncardiac chest pain of esophageal origin in patients with and without coronary artery disease.
OBJECTIVE
Non-cardiac chest pain is a frequent finding in patients admitted to emergency departments, and it has been shown that many of these patients may have an esophageal cause for their pain. However, little data are available on patients primarily referred to the cardiology unit, and especially those with coronary artery disease. The purpose of this study was to assess the role of esophageal dysfunction in chest pain patients with and without coronary artery disease.


METHODS
Eighty-one patients referred from a cardiology unit for chest pain and no myocardial infarction entered the study. Sixty-one patients had no evidence of coronary artery disease, whereas 20 had coronary artery disease with chest pain at rest. After the cardiological evaluation, the patients underwent esophageal function testing by means of upper endoscopy, manometry, and 24-hour pH-monitoring.


RESULTS
Overall, 10% of patients (2.5% in the coronary artery disease group) had evidence of endoscopic esophagitis, 46% of esophageal motor disorders (12% in the coronary artery disease group), and 10% abnormal pH-monitoring (1% in the coronary artery disease group).


CONCLUSIONS
We report that the esophagus might be responsible for non-cardiac chest pain in patients with and without coronary artery disease. In our experience, esophageal motor disorders, and not an increased acid reflux, are the abnormalities most commonly found in these patients.
Battaglia
Edda
E
Servizio di Endoscopia e Motilità Intestinale, Cattedra di Medicina Interna, Dipartimento di Fisiopatologia Clinica, Università di Torino, Italy.
Bassotti
Gabrio
G
Buonafede
Giuseppina
G
Serra
Anna Maria
AM
Dughera
Luca
L
Orzan
Fulvio
F
Casoni
Roberta
R
Chistolini
Fabio
F
Morelli
Antonio
A
Emanuelli
Giorgio
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D015984:Causality; D002637:Chest Pain / Q000453:epidemiology / Q000209:etiology*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology; D003325:Coronary Care Units / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000453:epidemiology; D004941:Esophagitis / Q000175:diagnosis* / Q000453:epidemiology; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged