Overview
Esophageal dysmotility refers to impaired motility of the esophagus, often manifesting as recurrent chest pain that can mimic cardiac pain. Despite persistent symptoms, long-term outcomes show reduced hospital admissions related to chest pain episodes 1.Diagnosis
Clinical Presentation: Recurrent chest pain, often indistinguishable from cardiac chest pain clinically 1.
Diagnostic Tests: Oesophageal manometry is crucial for confirming disturbances in motility 1.
Persistence: Manometric abnormalities often persist over time, as evidenced by repeat testing in patients 1.Management
First-Line Treatments: Limited specific drug recommendations in the abstract; symptomatic management and lifestyle modifications are implied 1.
Adjunctive Therapies: No specific adjunctive therapies detailed in the provided abstract 1.Special Populations
Long-Term Outcomes: In elderly patients, persistent symptoms are common, yet there is a noted reduction in hospital admissions over time 1.
Mortality: One patient died from myocardial infarction, highlighting the importance of differentiating esophageal from cardiac causes 1.Key Recommendations
Perform oesophageal manometry for definitive diagnosis of dysmotility (Evidence: Moderate 1).
Monitor patients longitudinally despite persistent symptoms, as hospital admissions may decrease over time (Evidence: Moderate 1).
Consider cardiac evaluation in patients with esophageal dysmotility due to potential overlap in symptoms (Evidence: Expert opinion 1).References
1 Swift GL, Alban-Davies H, McKirdy H, Lowndes R, Lewis D, Rhodes J. A long-term clinical review of patients with oesophageal pain. The Quarterly journal of medicine 1991. link