Esophageal dysfunction and chest pain in patients with mitral valve prolapse: A prospective study utilizing provocative testing during esophageal manometry

Kenneth L. Koch, William Davidson, Francis P. Day, Paul F. Spears, Stephen R. Voss

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

purpose: The cause of chest discomfort in patients with mitral valve prolapse (MVP) remains unknown. Our aim was to determine prospectively the incidence of esophageal disorders and abnormal responses to edrophonium chloride and esophageal acid infusions in patients with MVP and troublesome non-ischemic chest pain. patients and methods: After coronary artery disease was excluded, 20 patients with MVP and chest pain underwent esophageal manometry and provocative testing with edrophonium chloride and acid infusion. Seven patients with MVP but without chest pain served as control subjects; they also underwent esophageal manometry with provocative testing. results: Esophageal manometry revealed esophageal disorders in 16 patients: diffuse esophageal spasm in 14 patients, nutcracker esophagus in one, and hypotensive lower esophageal sphincter in one. Esophageal motility was normal in four patients. Injection of edrophonium and acid infusion tests evoked typical chest disomfort in three of 18 and five of 19 patients, respectively. In six of seven control subjects with MVP but with no chest discomfort, esophageal motility was normal and provocative testing did not produce chest discomfort (p <0.05 versus results in patients). conclusion: Esophageal disorders were common and may account for chest discomfort in certain patients with MVP and persistent chest pain syndromes.

Original languageEnglish (US)
Pages (from-to)32-38
Number of pages7
JournalThe American Journal of Medicine
Volume86
Issue number1 C
DOIs
StatePublished - Jan 1 1989

Fingerprint

Mitral Valve Prolapse
Manometry
Chest Pain
Prospective Studies
Edrophonium
Thorax
Acids
Diffuse Esophageal Spasm
Esophageal Motility Disorders
Lower Esophageal Sphincter
Coronary Artery Disease

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{59a91d8ad0a444e1b8e2c008d7a8335d,
title = "Esophageal dysfunction and chest pain in patients with mitral valve prolapse: A prospective study utilizing provocative testing during esophageal manometry",
abstract = "purpose: The cause of chest discomfort in patients with mitral valve prolapse (MVP) remains unknown. Our aim was to determine prospectively the incidence of esophageal disorders and abnormal responses to edrophonium chloride and esophageal acid infusions in patients with MVP and troublesome non-ischemic chest pain. patients and methods: After coronary artery disease was excluded, 20 patients with MVP and chest pain underwent esophageal manometry and provocative testing with edrophonium chloride and acid infusion. Seven patients with MVP but without chest pain served as control subjects; they also underwent esophageal manometry with provocative testing. results: Esophageal manometry revealed esophageal disorders in 16 patients: diffuse esophageal spasm in 14 patients, nutcracker esophagus in one, and hypotensive lower esophageal sphincter in one. Esophageal motility was normal in four patients. Injection of edrophonium and acid infusion tests evoked typical chest disomfort in three of 18 and five of 19 patients, respectively. In six of seven control subjects with MVP but with no chest discomfort, esophageal motility was normal and provocative testing did not produce chest discomfort (p <0.05 versus results in patients). conclusion: Esophageal disorders were common and may account for chest discomfort in certain patients with MVP and persistent chest pain syndromes.",
author = "Koch, {Kenneth L.} and William Davidson and Day, {Francis P.} and Spears, {Paul F.} and Voss, {Stephen R.}",
year = "1989",
month = "1",
day = "1",
doi = "10.1016/0002-9343(89)90226-X",
language = "English (US)",
volume = "86",
pages = "32--38",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier Inc.",
number = "1 C",

}

Esophageal dysfunction and chest pain in patients with mitral valve prolapse : A prospective study utilizing provocative testing during esophageal manometry. / Koch, Kenneth L.; Davidson, William; Day, Francis P.; Spears, Paul F.; Voss, Stephen R.

In: The American Journal of Medicine, Vol. 86, No. 1 C, 01.01.1989, p. 32-38.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Esophageal dysfunction and chest pain in patients with mitral valve prolapse

T2 - A prospective study utilizing provocative testing during esophageal manometry

AU - Koch, Kenneth L.

AU - Davidson, William

AU - Day, Francis P.

AU - Spears, Paul F.

AU - Voss, Stephen R.

PY - 1989/1/1

Y1 - 1989/1/1

N2 - purpose: The cause of chest discomfort in patients with mitral valve prolapse (MVP) remains unknown. Our aim was to determine prospectively the incidence of esophageal disorders and abnormal responses to edrophonium chloride and esophageal acid infusions in patients with MVP and troublesome non-ischemic chest pain. patients and methods: After coronary artery disease was excluded, 20 patients with MVP and chest pain underwent esophageal manometry and provocative testing with edrophonium chloride and acid infusion. Seven patients with MVP but without chest pain served as control subjects; they also underwent esophageal manometry with provocative testing. results: Esophageal manometry revealed esophageal disorders in 16 patients: diffuse esophageal spasm in 14 patients, nutcracker esophagus in one, and hypotensive lower esophageal sphincter in one. Esophageal motility was normal in four patients. Injection of edrophonium and acid infusion tests evoked typical chest disomfort in three of 18 and five of 19 patients, respectively. In six of seven control subjects with MVP but with no chest discomfort, esophageal motility was normal and provocative testing did not produce chest discomfort (p <0.05 versus results in patients). conclusion: Esophageal disorders were common and may account for chest discomfort in certain patients with MVP and persistent chest pain syndromes.

AB - purpose: The cause of chest discomfort in patients with mitral valve prolapse (MVP) remains unknown. Our aim was to determine prospectively the incidence of esophageal disorders and abnormal responses to edrophonium chloride and esophageal acid infusions in patients with MVP and troublesome non-ischemic chest pain. patients and methods: After coronary artery disease was excluded, 20 patients with MVP and chest pain underwent esophageal manometry and provocative testing with edrophonium chloride and acid infusion. Seven patients with MVP but without chest pain served as control subjects; they also underwent esophageal manometry with provocative testing. results: Esophageal manometry revealed esophageal disorders in 16 patients: diffuse esophageal spasm in 14 patients, nutcracker esophagus in one, and hypotensive lower esophageal sphincter in one. Esophageal motility was normal in four patients. Injection of edrophonium and acid infusion tests evoked typical chest disomfort in three of 18 and five of 19 patients, respectively. In six of seven control subjects with MVP but with no chest discomfort, esophageal motility was normal and provocative testing did not produce chest discomfort (p <0.05 versus results in patients). conclusion: Esophageal disorders were common and may account for chest discomfort in certain patients with MVP and persistent chest pain syndromes.

UR - http://www.scopus.com/inward/record.url?scp=0024494345&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024494345&partnerID=8YFLogxK

U2 - 10.1016/0002-9343(89)90226-X

DO - 10.1016/0002-9343(89)90226-X

M3 - Article

C2 - 2910093

AN - SCOPUS:0024494345

VL - 86

SP - 32

EP - 38

JO - American Journal of Medicine

JF - American Journal of Medicine

SN - 0002-9343

IS - 1 C

ER -