[Acute recurrent chest pain originating in the esophagus. A review]

In half of the patients admitted for observation for acute myocardial infarction, this diagnosis is disproved. Gastro-oesophageal reflux and/or disturbances of oesophageal motility are the cause of the thoracic pain resulting in hospitalization in 16-34% of these patients. In 13-59% of the patients with chronic recurrent thoracic pain without demonstrable ischaemic cardiac disease (IHD), oesophageal disease is, similarly, considered to be the cause of the pain. It is not possible to distinguish whether the pain is caused by oesophageal disease or IHD on the basis of the history, but the differential diagnosis is important as patients with pain on account of oesophageal disease have a good prognosis as regards mortality. The physical and mental conditions of the patients may be improved if the correct diagnosis is established and treatment instituted. Methods of examination to demonstrate oesophageal disease are described. On account of the frequency of the condition and the extent of the methods of examination, a programme of investigation is proposed for patients suspected of having thoracic pain due to oesophageal disease.