Esophageal disease as a cause of severe retrosternal chest pain
| Autor: | E.Douglas Wigle, Robert D. Henderson, Robert Roberts |
|---|---|
| Rok vydání: | 1975 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Myocardial Infarction Pain Critical Care and Intensive Care Medicine Chest pain Esophageal Diseases Angina Pectoris Coronary artery disease Diagnosis Differential Electrocardiography Thoracic Diseases Internal medicine medicine Humans Hernia Myocardial infarction Esophagus Hernia Diaphragmatic business.industry Esophageal disease Middle Aged medicine.disease Dysphagia Surgery medicine.anatomical_structure Hernia Hiatal Cardiology Female Myocardial infarction diagnosis medicine.symptom Cardiology and Cardiovascular Medicine business Deglutition Disorders |
| Zdroj: | Chest. 67(5) |
| ISSN: | 0012-3692 |
| Popis: | During one six-month period 11 patients were referred with a diagnosis of coronary artery disease, because of recurrent episodes of severe, prolonged retrosternal chest pain necessitating from one to seven hospital admissions per patient for "suspect myocardial infarction". In no instance was this diagnosis proved by electrocardiogram or serum enzyme changes, but 7 of the 11 patients had abnormal resting electrocardiograms. Selective coronary arteriograms were normal in 10 patients and revealed nonobstructive coronary artery disease in the 11th patient. Esophageal studies revealed hiatus hernia in 9 and mild to severe disordered motored activity of the esophagus in all 11. Acid perfusion into the esophagus reproduced the chest pain in nine patients and in the other two, the hiatus hernia was incarcerated. On direct questioning, all patients indicated that the pain was worsened by lying down and bending over, and in eight patients there was a history of pharyngoesophageal or gastroesophageal dysphagia. In this day when the problem of chest pain with normal coronary arteries is very topical, our report emphasizes the need to consider symptomatic esophageal disease in the differential diagnosis of this problem. |
| Databáze: | OpenAIRE |
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