Oesophageal Dysfunction in Non‐Infarction Coronary Care Unit Patients

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Abstract
Esophageal dysfunction (OD) is a common finding in patients discharged from a coronary care unit without definite diagnosis. Of 55 patients investigated with esophageal manometry, acid perfusion test and exercise ECG, 32 had signs of OD and 19 signs of ischemic heart disease (IHD). Symptoms such as heart burn, acid regurgitations, feeling of a lump in the throat, surfeitness after meals, chest pain at night and relief of chest pain when lying with the head raised were significantly more common in patients with OD than in patients with normal esophageal function. Chest pain was more often provoked by effort, emotions or cold and more often relieved by nitroglycerin in patients with signs of IHD than in those without. These pain-provoking factors were common in patients with OD. A careful case history with specific inquiry directed at not only cardiac but esophageal symptoms is important in the differential diagnosis of chest pain.