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心脏病门诊或作冠心病监护的病人中,10～30%无缺血性心脏病。20%的冠状血管造影者显示正常或轻微损害,与症状无关。极少病人的病史及疼痛时的ECG提示冠状动脉痉挛,且可用麦角新碱诱发时所作的血管造影证实。很久以前即已认识食管运动失调可致胸痛。食管与心脏有共同的神经支配,故食管引起的疼痛可酷似缺血性心脏病。咽下困难史是食管病变的有力线索,轻微间歇性咽下困难常被胸痛和对心脏的顾虑所掩盖,故必须特别加以询问。在美国,非心原性胸痛是进行食管测压的首要原因。文献中列举多种类型的食管运动失调,如弥漫性食管痉挛、干果钳型食管(nut cracker oesophagus)、高张性LES、非特异性食管运动失调和失弛缓症,“触痛
Outpatient cardiac disease or coronary heart disease monitoring of patients, 10 to 30% without ischemic heart disease. 20% of coronary angiographers show normal or slight damage, regardless of symptoms. ECGs of very few patients with medical history and pain suggest coronary artery spasms and can be confirmed by angiography when induced by ergonovine. A long time ago that esophageal dysfunction can cause chest pain. Esophagus and the heart have a common innervation, so the pain caused by esophageal resembles ischemic heart disease. The history of dysphagia is a powerful clue for esophageal disease. Slight intermittent dysphagia is often overshadowed by chest pain and heart-related concerns and must be specifically questioned. In the United States, non-cardiogenic chest pain is the primary reason for esophageal manometry. Various types of esophageal motility disorders are listed in the literature, such as diffuse esophageal spasm, nut cracker oesophagus, hyper tension LES, unspecific esophageal dyskinesia and achalasia, "tenderness