CHEST PAIN OF ESOPHAGEAL ORIGIN

Most of the studies on noncardiac chest pain in 1995 focused on the an alysis of prolonged ambulatory pH and pressure measurements, coexisten ce of cardiac and esophageal dysfunction, and esophageal pain percepti on. There is a drop in the diagnostic yield of 24-hour esophageal mano metry and pH monitoring when patients undergo the test outside the acu te care setting. The discrimination power of prolonged pH monitoring t o distinguish healthy control subjects from patients with typical refl ux symptoms and no esophagitis is poor. Exogenous recombinant human he moglobin induces simultaneous high-amplitude esophageal contractions f requently accompanied by retrosternal chest pain. Symptomatic and asym ptomatic reflux episodes have a different proximal spread and duration . Intraesophageal balloon inflation can provoke a reflex cardiac bradi arrhythmia in patients with diffuse esophageal spasm and atrial or atr ioventricular disturbances. Patients with noncardiac chest pain have a primary sensory abnormality rather than an abnormal perception second ary to a chronic motility disorder. A thoracoscopic esophageal long my otomy is now a therapeutic alternative in patients with esophageal dys motility and chest pain.