Document Detail


"Oesophageal angina" in patients with angina pectoris: a possible side effect of chronic therapy with nitroderivates and Ca-antagonists.
MedLine Citation:
PMID:  1392024     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The study was carried out on 18 patients with angina pectoris in whom the usual treatment with nitroderivatives and/or Ca-antagonists did not improve or prevent the angina-like chest pain in the absence of unstable angina. The patients underwent the following oesophageal examinations: X-ray, endoscopy-biopsy, manometry, acid perfusion test and 24-hour oesophageal pH ambulatory monitoring, the latter two being made in association with dynamic ECG. The presence of coronary insufficiency had been previously determined by means of ECG and scintigraphic stress tests and, when necessary, coronary arteriography was performed. In 10/18 patients severe oesophageal motor disorders were observed, the most frequent being diffuse oesophageal spasm. In the entire group the lower oesophageal sphincter basal tone was significantly lower than normal. In 14/18 patients a pathologic gastroesophageal reflux was detected: in 2 of these patients a temporal correlation between pain attacks and episodes of gastroesophageal reflux were observed in the absence of ECG modifications. Acid perfusion test induced the angina-like chest pain in another 2 patients without ECG modifications. In conclusion, the angina-like chest pain of these patients is not due to a failure of the antianginal therapy in relieving the coronary insufficiency, but is most probably related to gastroesophageal reflux. This oesophageal disorder may be considered a side effect caused by prolonged therapy with nitroderivatives and Ca-antagonists. In fact, these drugs decrease the lower oesophageal sphincter tone which is the main barrier against the reflux of gastric contents into the oesophagus so favoring gastroesophageal reflux and related disorders, including oesophageal pain.
Authors:
M Bortolotti; E Labriola; S Bacchelli; D Degli Esposti; P Sarti; F Brunelli; L Del Campo; L Barbara
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Italian journal of gastroenterology     Volume:  24     ISSN:  0392-0623     ISO Abbreviation:  Ital J Gastroenterol     Publication Date:  1992 Sep 
Date Detail:
Created Date:  1992-10-28     Completed Date:  1992-10-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8000544     Medline TA:  Ital J Gastroenterol     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  405-8     Citation Subset:  IM    
Affiliation:
Istituto di Clinica Medica e Gastroenterologia, Università di Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / diagnosis,  drug therapy*
Chest Pain / etiology
Diagnosis, Differential
Female
Gastroesophageal Reflux / chemically induced*,  diagnosis
Humans
Male
Middle Aged
Nifedipine / adverse effects*,  therapeutic use
Nitrates / adverse effects*,  therapeutic use
Chemical
Reg. No./Substance:
0/Nitrates; 21829-25-4/Nifedipine

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


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