Chest Pain and the Esophagus

Ole Frobert; Peter Funch-Jensen; Jens P. Bagger

doi:10.7326/0003-4819-126-9-199705010-00020

Letters |1 May 1997

Chest Pain and the Esophagus

Ole Frobert, MD, PhD; Peter Funch-Jensen, MD, DSc; Jens P. Bagger, MD, DSc

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IN RESPONSE:

With respect to reflux, quite a few of our patients had dyspeptic symptoms, but this reached statistical significance only in the case of dysphagia. Only one patient received omeprazole at study entry. We admit that patients with overt gastrointestinal symptoms were probably referred to a gastroenterologic center, but it is unlikely that patients with severe chest pain were not evaluated in the cardiac clinic and thus were not possible candidates for our study.

Because many variables can be extracted from 24-hour multiple-channel esophageal monitoring, it will always be possible to find single patients who exceed the mean ± 2 SDs of a control group in one or more variables. In this way, the more variables that are considered, the more patients can be expected to have an esophageal disorder. We wanted to overcome this by comparing groups. We also used patients as their own controls when comparing periods of pain with periods of no pain. To detect even the smallest sign of esophageal abnormalities, we amplified the signal from the pain periods by a time-weighted analysis. Still, nothing indicated the presence of esophageal abnormalities. Three of the 63 patients had a reflux index exceeding the mean ± 2 SDs of the controls. None of these 3 patients had an apparent concordance between reflux episodes and chest pain.

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Letters |1 May 1997

Chest Pain and the Esophagus

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Letters |1 May 1997

Chest Pain and the Esophagus

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