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Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
Noncardiac chest pain
Ronnie Fass1, Tomás Navarro-Rodriguez
1The Neuroenteric Clinical Research Group, Section of Gastroenterology, Department of Medicine, Southern Arizona VA Health Care System, Tucson, AZ 85723-0001, USA. Ronnie.Fass@va.gov
Abstract:
Noncardiac chest pain (NCCP) affects approximately 1 quarter of the adult population in the United States. The pathophysiology of the disorder remains to be fully elucidated. Identified underlying mechanisms for esophageal pain include gastroesophageal reflux disease (GERD), esophageal dysmotility, and visceral hypersensitivity. Aggressive antireflux treatment has been the main therapeutic strategy for GERD-related NCCP. NCCP patients with or without spastic esophageal motor disorders are responsive to pain modulators. The value of botulinum toxin injection, endoscopic treatment for GERD, and antireflux surgery in alleviating NCCP symptoms is limited.
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