Oesophageal dysfunction and angina pectoris in a Swedish population selected at random

From an urban Swedish population, samples of 25 and 55 year old men and women were examined with questionnaires, oesophageal manometry including acid perfusion test. An exercise ECG was performed in 55 year old men with anginalike pain. Oesophageal dysfunction (OD) defined as either a hiatal hernia, severe dysmotility or a positive related acid perfusion test was found in 12% of the younger population and in 29% of the older one. The frequency of angina pectoris according to the Rose questionnaire was 5% in the 25 year olds and 13% in the 55 year olds. OD was found in 44% of the older male group with angina pectoris at history. In the angina group objective signs of ischemic heart disease was found in 32%. At interview by a cardiologist in connection with exercise ECG, the angina pectoris diagnosis as assessed by questionnaire was reduced to 4% in the 55 year old men. In this group objective signs of ischemic heart disease or a history of myocardial infarction (CHD) were found in 94%. The others, classified by a physician as possible or no angina pectoris had a lower rate of CHD of 25% and 13% respectively. The angina pectoris group diagnosed according to Rose questionnaire contains more people with OD than with CHD. The diagnosis angina pectoris as ischemic heart disease should therefore not be set on the history alone.