Manometric findings during spontaneous chest pain in patients with presumed esophageal "spasms"

Nine patients with intermittent chest pain thought clinically to be secondary to esophageal "spasms" developed typical pain while being studied with an intraluminal transducer probe placed in the distal esophagus. Manometric changes from control periods were examined preceding and during pain episodes. No significant difference in distal esophageal wave duration or amplitude or in frequency of abnormal peristalsis was observed preceding or during pain episodes when compared with nonpain periods over a mean monitoring time of 227 min. No change from the nonpain periods in esophageal baseline pressure occurred during pain episodes, nor was there any other obvious manometric change by gross inspection of the tracings. We conclude that patients clinically suspected of having esophageal "spasms" as the source of chest pain frequently do not, regardless of the presence or absence of motility abnormalities on conventional esophageal manometric studies.