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Chest Pain with Normal Coronary Angiograms: Pathogenesis, Diagnosis and Management pp 49–60Cite as

Esophageal Abnormalities and “Linked-Angina” in Syndrome X

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Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 213))

Abstract

Approximately 10–30% of patients undergoing coronary angiography for the investigation of chest pain have normal coronary arteries [1–3]. Patients with angina pectoris and normal coronary angiogram who also have a positive exercise test are often defined as “syndrome X”. The spectrum of current controversy regarding the pathophysiology of syndrome X is wide [4,5]. Many syndrome X patients have an abnormal coronary flow reserve (microvascular angina) which provides support for an ischemic basis for this syndrome. However, many patients also have esophageal dysfunction. Esophageal abnormalities, which have been commonly reported in patients with chest pain and normal coronary arteries [6–8], can cause symptoms that closely mimic the chest pain produced by coronary artery disease, due to the common innervation of the heart and the esophagus. This chapter will focus on the relationship between cardiac and esophageal chest pain. The content of this work will be based on a prospective study that we carried out to ascertain the relative prevalence of abnormalities of esophageal function (motility and reflux disorders) and coronary flow reserve in strictly characterized syndrome X patients.

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Authors
  1. Anoop Chauhan
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Editors and Affiliations

  1. St George’s Hospital Medical School, London, UK

    Juan Carlos Kaski MD, MRCP, FACC, FESC (BHF Sugden Reader in Clinical Cardiology and Consultant Cardiologist, Head of Coronary Artery Disease Research Group) (BHF Sugden Reader in Clinical Cardiology and Consultant Cardiologist, Head of Coronary Artery Disease Research Group)

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© 1999 Springer Science+Business Media New York

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Chauhan, A. (1999). Esophageal Abnormalities and “Linked-Angina” in Syndrome X. In: Kaski, J.C. (eds) Chest Pain with Normal Coronary Angiograms: Pathogenesis, Diagnosis and Management. Developments in Cardiovascular Medicine, vol 213. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5181-2_4

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  • DOI: https://doi.org/10.1007/978-1-4615-5181-2_4

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7360-5

  • Online ISBN: 978-1-4615-5181-2

  • eBook Packages: Springer Book Archive

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