Esophageal dysmotility and acid sensitivity in patients with mitral valve prolapse and chest pain

• Published in: Diseases of the esophagus Vol. 16; no. 2; pp. 73 - 76
• Main Authors: Hammett, R. J. H., Hansen, R. D., Lorang, M., Bak, Y. T., Kellow, J. E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-01-2003
• Subjects: acid perfusion testing; Chest Pain - etiology; diffuse esophageal spasm; esophageal manometry; Esophageal Motility Disorders - complications; Esophageal Motility Disorders - epidemiology; Esophageal Motility Disorders - physiopathology; Female; Gastric Acid; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - physiopathology; Humans; Male; Manometry; Middle Aged; Mitral valve prolapse; Mitral Valve Prolapse - complications; Mitral Valve Prolapse - epidemiology; Mitral Valve Prolapse - physiopathology; non-cardiac chest pain; Prevalence; Prospective Studies
• ISSN: 1120-8694; 1442-2050
• DOI: 10.1046/j.1442-2050.2003.00299.x

SUMMARY
Mitral valve prolapse (MVP) patients often experience non‐cardiac chest pain. The aims of this study were to determine, in patients with non‐cardiac chest pain: (i) whether esophageal dysmotility is more common in patients with MVP than in patients without MVP; and (ii) if acid sensitivity is an important cause of the chest pain in MVP patients. Esophageal manometry and acid perfusion testing were performed in 277 consecutive patients with non‐cardiac chest pain. Patients with MVP (13 female, one male; mean age 49 years) were more likely (P = 0.01) to have esophageal dysmotility, while acid perfusion was less likely (P < 0.05) to provoke their chest pain, than in patients without MVP. The most common esophageal motor abnormalities detected in patients with and without MVP were diffuse esophageal spasm (prevalence, 57%) and non‐specific motor disorder (prevalence, 9%), respectively. This study, the first large prospective series examining possible esophageal sensorimotor correlates of chest pain in MVP patients, demonstrates that in the absence of a cardiac cause for chest pain, a specific esophageal motility disorder should be excluded, rather than assuming the chest pain is likely to be due to acid sensitivity.