Angina-like chest pain and exertional esophageal pH monitoring.

Objectives - Spontaneous chest pain attacks are uncommon during 24-hour eso phageal pH monitoring in patients suffering from angina-like chest pain sus pected to be acid-related. The aim of this study was to assess the diagnost ic value of exertional esophageal pH monitoring and to prove that exercise testing induces chest pain and gastro-esophageal reflux and therefore impro ves symptomatic correlation study. Methods - Forty three patients suffering from angina-like chest pain underw ent treadmill exercise testing during a 24-hour esophageal pH monitoring. S ymptom analysis was made using the symptom-association probability describe d by Weusten. Results - During the 24-hour pH monitoring, 10 patients (23%) had a patholo gic esophageal acid exposure, 20 (46%) experienced chest pain and 3 (7%) ha d a symptom association probability > 95%. During the exercise testing on a treadmill, 19 patients (44%) had gastro-esophageal reflux, and 14 (32%) ex perienced chest pain, coinciding with a gastro-esophageal reflux in 8 (19%) . After exercise testing, the symptom-association probability analysis was significantly changed in 9 patients (21%), > 95% in 6 patients (14%). Conclusion - Exercise testing on a treadmill induces chest pain episodes du ring a 24-hour esophageal pH monitoring and therefore improves symptomatic correlation study in patients suffering from angina-like chest pain.