Lieberman D
Oregon Health Sciences University School of Medicine, Portland.
Postgrad Med. 1989 Sep 1;86(3):207-12. doi: 10.1080/00325481.1989.11704398.
Noncardiac chest pain remains an enigma that often defies precise diagnosis. Overlap of symptoms between esophageal and cardiac disorders may make differentiation extremely difficult. Exclusion of coronary artery disease is a key element of the management of noncardiac chest pain. Once this is accomplished, the physician can address the fears and concerns of the patient with confidence and often avoid any diagnostic studies of the esophagus. When diagnostic studies are performed, the physician should be mindful of their limitations. Since gastroesophageal reflux disease is probably the most common cause of esophageal chest pain, prompt recognition and treatment of this disorder may provide relief for many patients. Future studies should address the relationship between physiologic events in the esophagus and chest pain.
非心源性胸痛仍然是一个谜，常常难以进行精确诊断。食管疾病和心脏疾病之间症状的重叠可能使鉴别诊断极其困难。排除冠状动脉疾病是管理非心源性胸痛的关键要素。一旦完成这一步，医生就能自信地处理患者的恐惧和担忧，并且常常可以避免对食管进行任何诊断性检查。当进行诊断性检查时，医生应该留意其局限性。由于胃食管反流病可能是食管性胸痛最常见的病因，迅速识别并治疗这种疾病可能会使许多患者症状缓解。未来的研究应该关注食管生理事件与胸痛之间的关系。
