High prevalence of gastroesophageal reflux in patients with clinical unstable angina and known coronary artery disease.
OBJECTIVE
Esophageal disease may mimic acute anginal pain. However, the prevalence of gastroesophageal reflux in the acute setting of patients with clinically unstable angina (UA) pectoris is not known. The aim of this study was to determine the co-existence of coronary artery disease (CAD) and gastroesophageal reflux in UA, and to study the feasibility of esophageal investigation in the chest pain unit.


METHODS
22 patients with clinical UA and confirmed CAD were monitored by continuous vector cardiography and pH-measurement during 24 h of observation. Symptoms of chest pain and episodes of ischemia and reflux were recorded.


RESULTS
11 patients (50%) showed abnormal gastroesophageal reflux and another three (14%) had an increased number of reflux episodes. pH-measurements and esophageal manometry were well tolerated. Few chest pain episodes were recorded during the study period, and no association between chest pain, reflux, and ischemia could be shown.


CONCLUSIONS
Esophageal reflux is common in patients with UA and established CAD. As reflux-related chest pain may imitate angina pectoris, it is clinically important that gastroesophageal examination in patients with UA seems to be feasible and well tolerated in the 'acute setting'.
Schultz
Tomas
T
Department of Medicine, Multidisciplinary Pain Center, Sahlgrens University Hospital/Ostra, Goteborg, Sweden. tomas.schultz@vgregion.se
Mannheimer
Clas
C
Dellborg
Mikael
M
Pilhall
Martin
M
Börjesson
Mats
M
D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D002637:Chest Pain / Q000209:etiology; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003937:Diagnosis, Differential; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015995:Prevalence; D014672:Vectorcardiography