Are oesophageal disorders a common cause of chest pain despite normal coronary anatomy?
From the Cardiothoracic Centre and 1 Oesophageal Investigation Unit, Guy’s and St Thomas’ Hospital, London, UK Introduction On average 20%, but up to 39%, of patients undergoing coronary angiography for the investigation of chest pain are found to have normal coronary anatomy.1 These patients have a cardiac morbidity and mortality close to the normal population on short- or long-term follow-up,2 and the tendency is to reassure and discharge them from follow-up. However, 50% continue to have chest pain and 50% remain or become unemployed (Table 1), therefore an effort should be made to make a positive diagnosis in order to start appropriate treatment. Abnormal oesophageal motility or reflux are found frequently in these patients (Tables 2 and 3), but how often these are causative remains uncertain.
