Abstract
One third to one half of patients presenting with chest pain have no evidence of coronary artery disease and are characterized as having non-cardiac chest pain. In a large subset of these patients, the esophagus can be the source of the symptoms. This paper summarizes recent progress in our understanding of chest pain of esophageal origin. The value of esophageal diagnostic evaluation in patients with chest pain and normal coronary arteries remains controversial. Symptomatic gastroesophagel reflux is the most common cause of chest pain of esophageal origin. The use of impedance planimetry has provided a better insight in the mechanisms underlying hypersensitivity to esophageal balloon distension. The high prevalence and likely role of panic disorder in patients with chest pain of non -cardica origin has been confirmed. Further investigations towards factors underlying atypical chest pain should include not only a gastrointestinal but also a psychological work-up. Finally, recent reports indicate the contribution of the esophagus to chest pain events in patients with known coronary artery disease.
Published Version
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