SPONTANEOUS NONCARDIAC CHEST PAIN - EVALUATION BY 24-HOUR AMBULATORY ESOPHAGEAL MOTILITY AND PH MONITORING
SPONTANEOUS NONCARDIAC CHEST PAIN - EVALUATION BY 24-HOUR AMBULATORY ESOPHAGEAL MOTILITY AND PH MONITORING
复制标题
DOI：
10.1016/0016-5085(88)90542-2
复制
发表时间：
1988-04-01
期刊：
影响因子：
29.4
通讯作者：
RICHTER, J
中科院分区：
文献类型：
--
作者：
PETERS, L;MAAS, L;RICHTER, J
Noncardiac chest pain can be a diagnostic dilemma because patients rarely experience spontaneous chest pain in the laboratory. Therefore, we studied 24 patients with chronic, daily, substernal chest pain with a prototype 24-h ambulatory esophageal motility and pH system. Spontaneous chest pain episodes were correlated with pH < 4 and abnormal motility changes (mean amplitude and duration, maximum amplitude and duration, or percentage of abnormal peristalsis) defined as exceeding the patient''s normal esophageal motility pattern. Twenty-two patients experienced a total of 92 spontaneous chest pain episodes. Eleven chest pain episodes (12%) occurred during abnormal motility, whereas 18 episodes (20%) were associated with pH < 4 and four episodes (4%) had both abnormalities. The majority of chest pain episodes, 59 events (64%), did not have any association with motility or pH. Abnormal maximum duration and amplitude were the motility changes most frequently associated with chest pain. Overall, 13 of 22 patients (59%) had at least one chest episode correlating with abnormal motility or pH (range 33%-100%). Therefore, we conclude that ambulatory esophageal motility and pH monitoring is useful in the evaluation of noncardiac chest pain. pH abnormalities (20%) are more commonly associated with chest pain than motility abnormalities (12%). However, the majority of chest pain episodes (64%) did not correlate with either abnormality and may be the result of lowered esophageal pain threshold for distension, i.e., the "irritable esophagus".
