Investigation of non-cardiac chest pain — which oesophageal test?

Five different tests were used to evaluate oesophageal function in 22 patients who presented to a cardiac unit with acute chest pain but whose cardiological investigations were negative. Eight patients had an abnormality on oesophagoscopy, 10 had an abnormal pH monitoring study, six had a positive acid infusion test, 10 had an abnormal manometric study and six had an abnormal oseophageal transit scintiscan. Concordance for the three tests of gastro-oesophageal reflux disease was low at 28%, and for the two tests of oesophageal motility only 55%. Only two patients had normal results in all five tests.