[Esophageal abnormalities in patients with chest pain and normal coronary angiograms].
OBJECTIVE
To evaluate the frequency and the variety of esophageal abnormalities in patients with chest pain and normal coronary angiograms.


METHODS
: We have conducted a prospective study including patients with noncardiac chest pain based on normal coronary angiograms. We performed for all patients an upper gastrointestinal endoscopy, 24-hour esophageal pH monitoring and stationary esophageal manometry.


RESULTS
Fifty patients were studied on a 3-year period (24 men and 26 women, mean age: 51.5 years). Gastroesophageal reflux disease was found on 24-hour esophageal pH monitoring in 29 patients (58%), associated with a good symptomatic correlation in 17 patients (34%). Esophageal motor disorders as nutcracker esophagus and diffuse esophageal spasm were found in 6 patients (12%) associated with gastroesophageal reflux disease in two cases. Independent factors associated with gastroesophageal reflux disease and esophageal motor disorders were respectively presence of regurgitations (p = 0.005 : adjusted OR[IC95%] : 3.57 [1.28 - 16.66]) and age higher than 58 years (p = 0.01 : adjusted OR[IC95%]: 2.77 [1.33 - 12.50]).


CONCLUSIONS
Gastroesophageal reflux disease is the most common esophageal abnormality n; patients with noncardiac chest pain. In the absence of regurgitations, 24-hour esophageal pH monitoring must be the first test to be performed.
Karoui
Sami
S
Service de Gastro-entérologie A. Hôpital la Rabta, Tunis.
Sami Mourali
Mohamed
M
Zouiten
Lilia
L
Matri
Samira
S
Djebbi
Saloua
S
Boubaker
Jalel
J
Cherif
Ali
A
Mechmeche
Rachid
R
Filali
Azza
A
D000328:Adult; D002637:Chest Pain / Q000209:etiology*; D017023:Coronary Angiography; D015154:Esophageal Motility Disorders / Q000150:complications / Q000175:diagnosis; D004945:Esophagoscopy; D004947:Esophagus / Q000002:abnormalities*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies