[Non-cardiac thoracic pain. Diagnosis, differential diagnosis and therapy]

In about 50% of the cases, non-cardiac chest pain is due to hypomotile or hypermotile functional disorders of the esophagus. X-ray examination, endoscopy and manometry, possibly with provocation with edrophonium, confirm the diagnosis. Gastro-esophageal reflux is found in 40%, motility disorders in 20%, and an irritable esophagus in 40% of the cases. For diagnosis ex juvantibus, gastroprokinetic drugs or H2-blockers, nitro compounds and calcium antagonists may be useful.