NON-INFARCTION CORONARY-CARE UNIT PATIENTS - A 3-YEAR FOLLOW-UP WITH SPECIAL REFERENCE TO ESOPHAGEAL DYSFUNCTION AND ISCHEMIC-HEART-DISEASE AS ORIGIN OF CHEST PAIN

  • 1 January 1981
    • journal article
    • research article
    • Vol. 209  (1-2) , 51-57
Abstract
Among 55 consecutive coronary care unit (CCU) patients with chest pain of unknown origin at discharge from hospital, signs of esophageal dysfunction (OD) were found in 58% and signs of ischemic heart disease (IHD) in 35% within 2-6 mo. At a 3 yr follow-up, signs of OD were found in 62% and signs of IHD in 28%. Patients (46; 84%) had experienced a pain similar to that which caused the CCU admission (i.e., the CCU chest pain). OD was regarded as the cause of the CCU chest pain in 7 patients (13%) and as a possible cause in another nine (16%). IHD was regarded as the cause of the CCU chest pain in 17 patients (31%), 4 of whom had died from acute myocardial infarction during the follow-up period. All 10 patients who developed coronary events, such as myocardial infarction or progressive angina pectoris, during the follow-up period had an ischemic ECG reaction at exercise test 2-6 mo. after discharge form the CCU. IHD was the predominant disease in terms of severity of symptoms and prognosis and was also recorded as the most common single cause of the CCU chest pain. Since OD was common and even caused severe chest pain in some patients, esophageal origin should be considered in the differential diagnosis of chest pain in non-infarction CCU patients.

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