High prevalence of gastroesophageal reflux in patients with clinical unstable angina and known coronary artery disease.

Objectives: Esophageal disease may mimic acute anginal pain. However, the prevalence of gastroesophageal reflux in the acute setting of patients with clinically unstable angina (UA) pectoris is not known. The aim of this study was to determine the co-existence of coronary artery disease (CAD) and gastroesophageal reflux in UA, and to study the feasibility of esophageal investigation in the chest pain unit.

Nutcracker oesophagus: a double-blind, placebo-controlled, cross-over study of the effects of lansoprazole.

Background: Nutcracker oesophagus is characterized by high-amplitude oesophageal contractions. Recent data have shown a high prevalence of gastro-oesophageal acid reflux in patients with nutcracker oesophagus and, in open-label trials, patients seemed to benefit from acid suppression. Therefore, it has been suggested that non-cardiac chest pain in patients with nutcracker oesophagus may be related to reflux rather than to the motor abnormality itself.

Diagnosis of nutcracker esophagus, segmental or diffuse hypertensive patterns, and clinical characteristics.

Different criteria have been used for the diagnosis of nutcracker esophagus, but the clinical importance of this is largely unknown. To this end, 45 patients with hypertensive esophageal peristalsis were identified from 572 esophageal investigations, and thereafter explored with regard to diagnostic criteria and clinical background data. The numbers of patients classified as having nutcracker esophagus with different criteria were 25 (by Richter criteria), 39 (by Achem criteria), and 45 (by Gothenburg criteria).

Gastroesophageal acid reflux in patients with nutcracker esophagus.

Background: Hypertensive esophageal contraction, called nutcracker esophagus (NE), is the most common motility abnormality associated with cardiac-like chest pain. However, its significance for the development of symptoms has been a matter of controversy for decades, and recently it has been suggested that NE might represent a primarily acid-related esophageal disorder. The frequency of acid-related esophageal dysfunction is studied in an unselected group of patients with NE.

Effects of spinal cord stimulation and coronary artery bypass grafting on myocardial ischemia and heart rate variability: further results from the ESBY study.

In the present study, 24-hour ECG recordings were analyzed from the Electrical Stimulation versus Coronary Artery Bypass Surgery (ESBY) Study where spinal cord stimulation was compared to CABG (coronary artery bypass grafting) in selected patients with severe angina pectoris. During the monitoring period, the spinal cord stimulation was discontinued to evaluate possible long-term effects of this treatment. The number of ischemic episodes and the duration of ischemia decreased in the CABG group at the follow-up when compared to spinal cord stimulation (p<0.