Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Feb 14, 2009; 15(6): 742-747
Published online Feb 14, 2009. doi: 10.3748/wjg.15.742
Diagnosis of chest pain with foregut symptoms in Chinese patients
Bo Deng, Ru-Wen Wang, Yao-Guang Jiang, Qun-You Tan, Xiang-Li Liao, Jing-Hai Zhou, Yun-Ping Zhao, Tai-Qian Gong, Zheng Ma
Bo Deng, Ru-Wen Wang, Yao-Guang Jiang, Qun-You Tan, Xiang-Li Liao, Jing-Hai Zhou, Yun-Ping Zhao, Tai-Qian Gong, Zheng Ma, Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, The Third Military Medical University, Chongqing 400042, China
Author contributions: Deng B, Wang RW and Jiang YG diagnosed patients, analyzed the data and wrote the manuscript; Tan QY, Liao XL, Zhou JH, Zhao YP, Gong TQ and Ma Z collected the data.
Correspondence to: Ru-Wen Wang, MD, Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, The Third Military Medical University, Chongqing 400042, China. superdb@163.com
Telephone: +86-23-68757983
Fax: +86-23-68890331
Received: September 18, 2008
Revised: November 16, 2008
Accepted: November 23, 2008
Published online: February 14, 2009
Abstract

AIM: To evaluate the diagnosis of chest pain with foregut symptoms in Chinese patients.

METHODS: Esophageal manometric studies, 24-h introesophageal pH monitoring and 24-h electrocardiograms (Holter electrocardiography) were performed in 61 patients with chest pain.

RESULTS: Thirty-nine patients were diagnosed with non-specific esophageal motility disorders (29 patients with abnormal gastroesophageal reflux and eight patients with myocardial ischemia). Five patients had diffuse spasm of the esophagus plus abnormal gastroesophageal reflux (two patients had concomitant myocardial ischemia), and one patient was diagnosed with nutcracker esophagus.

CONCLUSION: The esophageal manometric studies, 24-h intra-esophageal pH monitoring and Holter electrocardiography are significant for the differential diagnosis of chest pain, particularly in patients with foregut symptoms. In cases of esophageal motility disorders, pathological gastroesophageal reflux may be a major cause of chest pain with non-specific esophageal motility disorders. Spasm of the esophageal smooth muscle might affect the heart-coronary smooth muscle, leading to myocardial ischemia.

Keywords: Chest pain; Esophageal manometric; Twenty-four-hour intra-esophageal pH monitoring; Holter electrocardiography