Lieberman D A, Jendrzejewski J W, McAnulty J H
West J Med. 1984 Mar;140(3):403-8.
In many patients with chest pain of esophageal origin, findings are normal on routine esophageal manometry and dysmotility develops only upon provocation with ergonovine maleate. Unfortunately, ergonovine may induce myocardial ischemia in patients in whom coronary artery spasm did not occur during previous provocative testing in a cardiac laboratory-limiting its clinical usefulness. We have recorded esophageal pressure simultaneously with ergonovine infusion during angiography in ten patients without significant arterial stenoses. In two patients their usual chest pain developed associated with esophageal spasm and without changes in coronary vessels. Simultaneous performance of angiography and manometry enhanced the diagnostic yield of provocative testing by showing esophageal motility changes. This method may detect significant changes in the esophageal motility, is easy to carry out and does not interfere with angiography. It maximizes the information gained from a single provocative test and avoids the risk of ergonovine infusion outside of a cardiac laboratory.
在许多有食管源性胸痛的患者中，常规食管测压结果正常，仅在使用马来酸麦角新碱激发时才出现动力障碍。不幸的是，麦角新碱可能会在心脏实验室先前激发试验期间未发生冠状动脉痉挛的患者中诱发心肌缺血，从而限制了其临床应用价值。我们在血管造影期间对10例无明显动脉狭窄的患者在输注麦角新碱时同时记录食管压力。在2例患者中，他们出现了与食管痉挛相关的典型胸痛，冠状动脉血管无变化。血管造影和测压同时进行，通过显示食管动力变化提高了激发试验的诊断率。这种方法可以检测食管动力的显著变化，易于实施且不干扰血管造影。它能最大限度地从单次激发试验中获取信息，并避免在心脏实验室之外输注麦角新碱的风险。
