Castell D O
Geriatrics. 1985 Oct;40(10):61-3, 67, 70 passim.
Barium swallow and gallbladder study may reveal esophageal or gastric cancer, esophageal or duodenal ulcer, or gallstones. If serious GI tract disorders such as these are ruled out, the next step is to seek an esophageal source of recurring chest pain. Intraesophageal acid infusion and edrophonium chloride (Tensilon) stimulation can be used in the office to reproduce chest pain secondary to an esophageal disorder. With either test, reproduction of the patient's typical chest pain is positive. About one-third of patients seen in our laboratory with noncardiac chest pain have a positive response.
吞钡检查和胆囊检查可能会发现食管癌、胃癌、食管或十二指肠溃疡或胆结石。如果排除了这类严重的胃肠道疾病，下一步就是寻找反复胸痛的食管病因。可在门诊进行食管内酸灌注和氯化腾喜龙（腾喜龙）刺激试验，以再现由食管疾病引起的胸痛。在这两种检查中，患者典型胸痛再现即为阳性。在我们实验室就诊的非心源性胸痛患者中，约三分之一会有阳性反应。
