摘要:

ABSTRACT.A patient with invagination into the oesophagus of gastric mucosal folds is described. He was referred with chest pain and was evaluated by cinematographic x‐ray examination, endoscopy and pressure‐ and pH‐probe investigations. After medical treatment he was operated on with a modified Belsey procedure and got pai

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03124.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.Oesophageal dysfunction (OD), ischaemic heart disease (IHD) and their relation to chest pain were studied in two groups of patients. A group of 55 non‐infarction coronary care unit patients were investigated within 6 months and at a three‐year follow‐up, and 52 male patients were studied within 6 months after an acute myocardial infarction. Oesophageal manometry, pH recording, acid perfusion test, ECG at rest and exercise, history by questionnaire and by interview were used as diagnostic tools. Non‐infarction coronary care unit patients with unknown origin of their chest pain at discharge from hospital had a higher frequency of OD (58%) than patients with recent myocardial infarction (33%, p<0.05). In 7 of 55 (13%) non‐infarction patients OD was regarded as the cause and in 17 (31%) IHD was regarded as the cause of the pain on admission to the coronary care unit. OD was an uncommon cause of angina‐like chest pain in patients with recent myocardial infarction (1 of 38 patients). Patients with OD had a higher frequency of oesophageally related questionnaire symptoms than patients with normal oesophageal function. For the differential diagnosis of chest pain a careful history is essential. Reproduction of the patient's chest pain during oesophageal acid perfusion test or exercise test offers additional valuable

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03125.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.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.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03126.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.Ninety‐eight patients previously investigated for suspected angina but shown to have normal coronary arteriograms were reviewed. The prognosis for life expectancy was excellent but 76% were still symptomatic after average follow up of three years. 41% of those re‐evaluated were still thought to be describing cardiac‐like pain. Full re‐investigation showed coronary artery spasm or other causes of myocardial ischaemia to be rare whereas oesophageal spasm was a common cause of t

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03127.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.Twenty‐two patients with chest pain and normal coronary angiograms were given intravenously ergometrine while oesophageal manometry was being carried out. Thirteen of the patients had neither pain nor significant motility disturbance after ergometrine. Ergometrine provocation enabled a diagnosis to be made in nine patients in whom routine investigations of the oesophagus were norma

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03128.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.The pain conducting systems in the thorax will be described. The diagnosis angina pectoris is a symptom diagnosis. The common medical assumption is that these symptoms are caused by decreased circulation in the coronary vessels. The truth is that exactly the same symptoms can be the results of pathological changes in for example the oesophagus, the mediastinum and the thoracic spine. Our knowledge of referred pain and the pathways for pain conduction permits us nowadays to understand how pain symptoms can have different origins and still be experienced as identical.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03129.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.Pain identical with angina pectoris can be released from the disks Th4‐5, Th5‐6 and Th6‐7. Most common, cardiac‐like pain is elicited from Th5‐6. Physical stress such as lifting, rotation of the thorax and heavy work is especially symptom provoking. It is not unusual that movements in the bed during the night can provoke a pain attack. The pain can subside after a while but more often it continues for a long time in spite of rest. In all patients with symptoms of angina pectoris the thoracic spine should be examined. Pressing on the spinous process of the Th5 usually elicits an intensive and typical pain. The verification of the diagnosis is made by a »specific« investigation of the spine and ‐ ex juvantibus ‐ by the momentary relief of pain after manipulation of the actual

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03130.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT.The frequency of segmental thoracic pain in 1097 patients admitted complaining of chest pain was investigated by specific examination of the thoracic vertebrae and segments. The examination is easily performed with minimal risk to possible coronary patients. Segmental thoracic pain accounts for 13% of chest pains in a medical department, making it the third most common chest pain (behind coronary thrombosis pain 39%, angina pectoris 20%). Treatment by local paravertebral anaesthesia is simple and effective in most cases.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03131.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03132.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb03133.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY