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KMID : 0614619950270040381
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Korean Journal of Gastroenterology
1995 Volume.27 No. 4 p.381 ~ p.387
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Significance of Esophageal Motility Test in Patients with noncardiac Chest pain
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송치욱
구양서/이홍식/이상우/최재현/김창덕/류호상/현진해
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Abstract
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Background/Aims:
@EN Recently the esophagus is considered a major source of recurrent noncardiac chest pain to patients in whom exercise stress test and/or cardiac catheterization have excluded a cardiac etiology. to investigate the esophageal origin of
noncardiac
chest
pain, esophageal motility tests including manometry, provocation test, and radioisotope esophahgeal transit study (RETS) were studied in patients with noncardiac chest pain.
@ES Methods:
@EN A total of 126 patients with noncardiac chest pain were assessed; they included 41 patients with normal coronary angiogram and 85 patients with normal noninvasive cardiac tests such as echocardiogram and exercise stress test done in Korea
University
Hospital from Feb. 1993 to Aug. 1994.
@ES Results:
@EN 56 out of 126 patients (44.4%) with noncardiac chest pain had abnormal manometric findings which included 20 (35.7%) nonspecific esophageal motility disorder, 17 (30.4%) hypertensive lower esophageal sphincter, 9 (16.1%) hypotensive lower
esophageal
sphincter, and 2 (3.6%) nutcracker esophagus. Thirty eight out of 126 (30.1%). patients had abnormal manometric findings but no reproducible chest pain by provocation test and were considered to have a probable esophageal chest pain. When
patients
having positives for both provocation tests are counted as a single positive, 39 out of 126 (31%) patients had their chest pain reproduced and were considered to have a definite esophageal chest pain. The combination of patients with definite
esophageal
chest pain (31%) and probable (30.1%) gave and overall diagnostic yield of 61.1% for our esophageal laboratory. There was no significant difference between invasive cardiac test group and noninvasive cardiac test group in the results of
esophageal
motility tests. RETS merely reflected the peristaltic abnormalities with no more informations for esophageal chest pain.
@ES Conclusions:
@EN These results reveal that esophagus is considered a source of noncarcdiac chest pain in 61.1%. Provocation test complements esophageal manometry alone and increases diagnostic yield. RETS can be used in diagnosis of noncardiac chest pain
accompanied
by peristaltic abnormality of the esophagus. (Korean J Gastroenterol 1995; 27: 381-387)
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