What are the characteristics of angina-like chest pain ?
J-Y. Touchais, Ph. Ducrotte, Ph. Denis (Rouen)
Angina-like chest pain can arise from the esophagus and often clinically resembles angina pectoris due to coronary artery disease: substernal pain induced by effort or emotion and radiating to the neck, jaw or back, with a few minutes duration and associated with anxiety, sweating and lipothymia; pain relief is obtained by rest or follows treatment by nitroglycerin or calcium-antagonists.
However, some characteristics of the pain in esophageal disorders are considered to be helpful in defining its origin: radiation to the back, prolonged duration as long as several hours or even one or two days, association with dysphagia, temporal relationship between its occurrence and heartburn or acid regurgitation, provocation by food, hot or cold drinks, relief by antacids . However, none of these characteristics is specific: indeed, the prevalence of motor esophageal disorders is about 50-70 p. cent in patients with coronary artery disease. Moreover, esophageal symptoms are found in more than half of the patients with chest pain of cardiac origin.
Therefore, angina-like chest pain of esophageal origin is often clinically indistinguishable from the angina pectoris of ischemic heart disease.