High-amplitude peristaltic esophageal contractions associated with chest pain
M. Traube, R. Albibi and R. W. McCallum
Review of esophageal motility tracings performed during a three-year period
yielded 112 patients who underwent the test because of chest pain of
unclear etiology. Thirteen patients had high-amplitude peristaltic
contractions. All 13 patients had pressurelike pain, ten had dysphagia, and
six had symptoms of gastroesophageal reflux. The presence of an elevated
lower esophageal sphincter pressure in five patients suggested a spectrum
of hypertensive disorders of the esophagus variously affecting the body,
the sphincter, or both. This latter subgroup responded to esophageal
bougienage. Six patients had objective evidence for gastroesophageal
reflux. These patients had at least partial relief from antireflux
measures. High-amplitude peristaltic contractions should be considered in
the differential diagnosis of noncardiac chest pain, since recognition of
this entity can lead to appropriate management and symptom relief.
