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Esophageal dysfunction in syndrome X

M Börjesson¹, P Albertsson, M Dellborg

¹Department of Medicine, Sahlgrenska University Hospital/Ostra, Göteborg University, Sweden. mats.borjesson@medfak.gu.se

The American Journal of Cardiology

|December 1, 1998

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Syndrome X, characterized by chest pain with normal coronary arteries, may stem from esophageal hypersensitivity. Acid reflux in a sensitive esophagus is a key factor, with acid suppression therapy improving symptoms in many patients.

Area of Science:

Cardiology
Gastroenterology

Background:

Syndrome X presents as anginal chest pain despite normal coronary arteries.
The exact cause of Syndrome X remains unclear, with esophageal dysfunction and visceral hypersensitivity being potential contributors.

Purpose of the Study:

To investigate esophageal function and visceral sensitivity in patients diagnosed with Syndrome X.

Main Methods:

Twenty patients with Syndrome X underwent esophageal manometry and 24-hour pH monitoring.
Esophageal visceral sensitivity was assessed using balloon distention and acid instillation.

Main Results:

Abnormalities in 24-hour pH monitoring were found in 67% of patients.
Esophageal dysmotility was present in 35% of patients, including "nutcracker" esophagus.

Related Experiment Videos

Esophageal hypersensitivity to acid or distention was observed in 70% of patients.

Conclusions:

Esophageal hypersensitivity, particularly to acid, appears to be a significant factor in Syndrome X chest pain.
Acid suppression therapy provided pain relief for 73% of treated patients, suggesting acid's role.