Document Detail


Angina-like chest pain associated with high-amplitude peristaltic contractions of the esophagus.
MedLine Citation:
PMID:  3175868     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We reviewed 123 consecutive patients who underwent esophageal function testing to determine the prevalence and clinical characteristics of the syndrome of high-amplitude peristaltic contractions (HAPC). Twenty-eight patients (23%) were found to have HAPC, including 16 males and 12 females with a median age of 54 years. Barium esophograms yielded no evidence of motility disorders, while 35% of those tested had pathologic gastroesophageal acid reflux. Twenty (71%) were initially referred for evaluation of angina-like chest pain, and 8 were referred with other symptoms. Of those with chest pain, 19 initially underwent extensive evaluation for coronary artery disease before the diagnosis of HAPC. Symptoms of heartburn, regurgitation, and dysphagia were absent or minimal in most patients. Lower esophageal sphincter pressure was normal in 27 patients, and lower esophageal sphincter relaxation was normal in all patients. Mean distal esophageal peak peristaltic pressure was 147.8 mm Hg, while the highest peak peristaltic pressure for each patient averaged 193.2 mm Hg. Seven patients had mean peristaltic wave durations of more than 7 seconds. Patients with atypical chest pain or those with typical angina in whom coronary artery disease is eliminated as a possible cause should be evaluated for HAPC with esophageal manometry. Patients with symptoms are usually successfully treated with smooth muscle relaxants, and surgical intervention is rarely necessary.
Authors:
M K Ferguson; A G Little
Related Documents :
8076988 - Ultrastructural changes in mild gastroesophageal reflux disease: results of a pilot study.
9362188 - Reduced chemoreceptor sensitivity in patients with barrett's esophagus may be related t...
16425388 - Characteristics of patients with columnar-lined barrett's esophagus and risk factors fo...
19565158 - Acoustic analysis of swallowing sounds: a new technique for assessing dysphagia.
592068 - Management of major hemoptysis in patients with cystic fibrosis.
3768098 - Alcohol-related diseases associated with ischaemic heart disease: a three-year follow-u...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Surgery     Volume:  104     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1988 Oct 
Date Detail:
Created Date:  1988-11-07     Completed Date:  1988-11-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  713-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Chicago Medical Center, Ill 60637.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Angina Pectoris / physiopathology
Chest Pain*
Coronary Disease / diagnosis
Diagnosis, Differential
Esophageal Motility Disorders / diagnosis,  physiopathology*
Esophagus / physiopathology
Female
Gastroesophageal Reflux / physiopathology
Humans
Male
Manometry
Middle Aged
Peristalsis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Twelve-year clinical experience with the Greenfield vena caval filter.
Next Document:  Aggressive treatment of chylothorax complicating transhiatal esophagectomy without thoracotomy.