Skip to main content
SpringerLink
Log in

Esophageal Chest Pain

  • Chapter
  • First Online:
Chest Pain with Normal Coronary Arteries

  • 1217 Accesses

Abstract

Non-cardiac chest pain (NCCP) consists of recurrent angina-type pain unrelated to ischemic heart disease or other cardiac source after a reasonable workup. The most common esophageal cause of NCCP is gastro-esophageal reflux disease (GERD), followed by esophageal motor disorders and esophageal visceral hypersensitivity. Noxious triggers for NCCP include acidic and non-acidic reflux events, mechanical distension and muscle spasm, particularly longitudinal smooth muscle contraction. Functional chest pain of esopha­geal origin is diagnosed when endoscopy and esophageal physiologic studies (manometry, ambulatory pH/pH-impedance monitoring) do not reveal a source for NCCP. Once a cardiac etiology has been reliably excluded, an empiric proton pump inhibitor (PPI) trial provides a clinically useful and cost effective mechanism for diagnosis of GERD related NCCP. While endoscopy has a limited diagnostic yield because of the high prevalence of nonerosive disease, histopathology may help evaluate for microscopic evidence of reflux and eosinophilic esophagitis. Ambulatory pH or pH/impedance monitoring off PPI therapy assesses for abnormal esophageal acid exposure and reflux association with NCCP events using simple and statistical symptom association probability tests. Esophageal manometry is typically performed concurrent with ambulatory pH monitoring and can identify esophageal dysmotility, some patterns of which may be associated with esophageal hypersensitivity. Acid suppression with a PPI is the first therapeutic measure initiated even prior to investigation in NCCP. Pain modulators (e.g. low dose tricyclic antidepressants) are often the mainstay of therapy in refractory situations. Smooth muscle relaxants (sublingual nitroglycerine, phosphodiesterase-5 inhibitors, and calcium channel blockers) can be used in hypermotility states, although their efficacy has not been conclusively demonstrated in controlled trials. Hypnotherapy, biofeedback, transcutaneous nerve stimulation, and cognitive and behavioral therapy complement pharmacologic therapy, although additional ­studies are needed; acupuncture may also be of benefit.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fass R, Malagon I, Schmulson M. Chest pain of esophageal origin. Curr Opin Gastroenterol. 2001;17(4):376–80.

    Article  PubMed  CAS  Google Scholar 

  2. Eslick GD, Fass R. Noncardiac chest pain: evaluation and treatment. Gastroenterol Clin North Am. 2003;32(2):531–52.

    Article  PubMed  Google Scholar 

  3. Lenfant C. Chest pain of cardiac and noncardiac origin. Metabolism. 2010;59 Suppl 1:S41–6.

    Article  PubMed  CAS  Google Scholar 

  4. Davies HA, Jones DB, Rhodes J, Newcombe RG. Angina-like esophageal pain: differentiation from cardiac pain by history. J Clin Gastroenterol. 1985;7(6):477–81.

    Article  PubMed  CAS  Google Scholar 

  5. Eslick GD. Chest pain: a historical perspective. Int J Cardiol. 2001;77(1):5–11.

    Article  PubMed  CAS  Google Scholar 

  6. Fass R, Achem SR. Noncardiac chest pain: epidemiology, natural course and pathogenesis. J Neurogastroenterol Motil. 2011;17(2):110–23.

    Article  PubMed  Google Scholar 

  7. Oranu AC, Vaezi MF. Noncardiac chest pain: gastroesophageal reflux disease. Med Clin North Am. 2010;94(2):233–42.

    Article  PubMed  CAS  Google Scholar 

  8. Pandak WM, Arezo S, Everett S, et al. Short course of omeprazole: a better first diagnostic approach to noncardiac chest pain than endoscopy, manometry, or 24-hour esophageal pH monitoring. J Clin Gastroenterol. 2002;35(4):307–14.

    Article  PubMed  CAS  Google Scholar 

  9. Kushnir VM, Sayuk GS, Gyawali CP. Abnormal GERD parameters on ambulatory pH monitoring predict therapeutic success in noncardiac chest pain. Am J Gastroenterol. 2010;105(5):1032–8.

    Article  PubMed  Google Scholar 

  10. Nasr I, Attaluri A, Hashmi S, Gregersen H, Rao SS. Investigation of esophageal sensation and biomechanical properties in functional chest pain. Neurogastroenterol Motil. 2010;22(5):520–6, e116.

    PubMed  CAS  Google Scholar 

  11. Locke 3rd GR, Talley NJ, Fett SL, Zinsmeister AR, Melton 3rd LJ. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroen­terology. 1997;112(5):1448–56.

    Article  PubMed  Google Scholar 

  12. Eslick GD, Jones MP, Talley NJ. Non-cardiac chest pain: prevalence, risk factors, impact and consulting–a population-based study. Aliment Pharmacol Ther. 2003;17(9):1115–24.

    Article  PubMed  CAS  Google Scholar 

  13. Rey E, Rodriguez-Artalejo F, Herraiz MA, Alvarez-Sanchez A, Escudero M, Diaz-Rubio M. Atypical symptoms of gastro-esophageal reflux during pregnancy. Rev Esp Enferm Dig. 2011;103(3):129–32.

    Article  PubMed  CAS  Google Scholar 

  14. Miwa H, Kondo T, Oshima T, Fukui H, Tomita T, Watari J. Esophageal sensation and esophageal hypersensitivity – overview from bench to bedside. J Neurogastroenterol Motil. 2010;16(4):353–62.

    Article  PubMed  Google Scholar 

  15. Lasch H, Castell DO, Castell JA. Evidence for diminished visceral pain with aging: studies using graded intraesophageal balloon distension. Am J Physiol. 1997;272(1 Pt 1):G1–3.

    PubMed  CAS  Google Scholar 

  16. Fass R, Pulliam G, Johnson C, Garewal HS, Sampliner RE. Symptom severity and oesophageal chemosensitivity to acid in older and young patients with gastro-oesophageal reflux. Age Ageing. 2000;29(2):125–30.

    Article  PubMed  CAS  Google Scholar 

  17. Fang J, Bjorkman D. A critical approach to noncardiac chest pain: pathophysiology, diagnosis, and treatment. Am J Gastroenterol. 2001;96(4):958–68.

    Article  PubMed  CAS  Google Scholar 

  18. Achem SR. Noncardiac chest pain-treatment approaches. Gastroenterol Clin North Am. 2008;37(4):859–78, ix.

    Article  PubMed  Google Scholar 

  19. Bautista J, Fullerton H, Briseno M, Cui H, Fass R. The effect of an empirical trial of high-dose lansoprazole on symptom response of patients with non-cardiac chest pain–a randomized, double-blind, placebo-controlled, crossover trial. Aliment Pharmacol Ther. 2004;19(10):1123–30.

    Article  PubMed  CAS  Google Scholar 

  20. Lee MM, Enns R. Narrow band imaging in gastroesophageal reflux disease and Barrett’s esophagus. Can J Gastroenterol. 2009;23(2):84–7.

    PubMed  Google Scholar 

  21. Gawron AJ, Hirano I. Advances in diagnostic testing for gastroesophageal reflux disease. World J Gastroenterol. 2010;16(30):3750–6.

    Article  PubMed  Google Scholar 

  22. Kushnir VM, Sayuk GS, Gyawali CP. The effect of antisecretory therapy and study duration on ambulatory esophageal pH monitoring. Dig Dis Sci. 2011;56(5):1412–19.

    Article  PubMed  Google Scholar 

  23. Prakash C, Clouse RE. Value of extended recording time with wireless pH monitoring in evaluating gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2005;3(4):329–34.

    Article  PubMed  Google Scholar 

  24. Prakash C, Clouse RE. Wireless pH monitoring in patients with non-cardiac chest pain. Am J Gastroenterol. 2006;101(3):446–52.

    Article  PubMed  Google Scholar 

  25. Richter JE, Barish CF, Castell DO. Abnormal sensory perception in patients with esophageal chest pain. Gastroenterology. 1986;91(4):845–52.

    PubMed  CAS  Google Scholar 

  26. Rao SS, Gregersen H, Hayek B, Summers RW, Christensen J. Unexplained chest pain: the hypersensitive, hyperreactive, and poorly compliant esophagus. Ann Intern Med. 1996;124(11):950–8.

    PubMed  CAS  Google Scholar 

  27. Borjesson M, Pilhall M, Eliasson T, Norssell H, Mannheimer C, Rolny P. Esophageal visceral pain sensitivity: effects of TENS and correlation with manometric findings. Dig Dis Sci. 1998;43(8):1621–8.

    Article  PubMed  CAS  Google Scholar 

  28. Winslow ER, Clouse RE, Desai KM, et al. Influence of spastic motor disorders of the esophageal body on outcomes from laparoscopic antireflux surgery. Surg Endosc. 2003;17(5):738–45.

    Article  PubMed  CAS  Google Scholar 

  29. Balaban DH, Yamamoto Y, Liu J, et al. Sustained esophageal contraction: a marker of esophageal chest pain identified by intraluminal ultrasonography. Gastroenterology. 1999;116(1):29–37.

    Article  PubMed  CAS  Google Scholar 

  30. Mujica VR, Mudipalli RS, Rao SS. Pathophysiology of chest pain in patients with nutcracker esophagus. Am J Gastroenterol. 2001;96(5):1371–7.

    Article  PubMed  CAS  Google Scholar 

  31. Rao SS, Hayek B, Summers RW. Functional chest pain of esophageal origin: hyperalgesia or motor dysfunction. Am J Gastroenterol. 2001;96(9):2584–9.

    Article  PubMed  CAS  Google Scholar 

  32. Park H, Conklin JL. Neuromuscular control of esophageal peristalsis. Curr Gastroenterol Rep. 1999;1(3):186–97.

    Article  PubMed  CAS  Google Scholar 

  33. Yazaki E, Sifrim D. Anatomy and physiology of the esophageal body. Dis Esophagus. 2012;25(4):292–8.

    Article  PubMed  CAS  Google Scholar 

  34. Clouse RE, Carney RM. The psychological profile of non-cardiac chest pain patients. Eur J Gastroenterol Hepatol. 1995;7(12):1160–5.

    Article  PubMed  CAS  Google Scholar 

  35. Schey R, Dickman R, Parthasarathy S, et al. Sleep deprivation is hyperalgesic in patients with gastroesophageal reflux disease. Gastroenterology. 2007;133(6):1787–95.

    Article  PubMed  Google Scholar 

  36. Bradley LA, Richter JE, Pulliam TJ, et al. The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors. Am J Gastroenterol. 1993;88(1):11–9.

    PubMed  CAS  Google Scholar 

  37. Sayuk GS, Elwing JE, Lustman PJ, Clouse RE. Predictors of premature antidepressant discontinuation in functional gastrointestinal disorders. Psychosom Med. 2007;69(2):173–81.

    Article  PubMed  CAS  Google Scholar 

  38. Prasad GA, Alexander JA, Schleck CD, et al. Epidemiology of eosinophilic esophagitis over three decades in Olmsted County, Minnesota. Clin Gastroenterol Hepatol. 2009;7(10):1055–61.

    Article  PubMed  Google Scholar 

  39. Croese J, Fairley SK, Masson JW, et al. Clinical and endoscopic features of eosinophilic esophagitis in adults. Gastrointest Endosc. 2003;58(4):516–22.

    Article  PubMed  Google Scholar 

  40. Noel RJ, Putnam PE, Rothenberg ME. Eosinophilic esophagitis. N Engl J Med. 2004;351(9):940–1.

    Article  PubMed  CAS  Google Scholar 

  41. Atkins D, Kramer R, Capocelli K, Lovell M, Furuta GT. Eosinophilic esophagitis: the newest esophageal inflammatory disease. Nat Rev Gastroenterol Hepatol. 2009;6(5):267–78.

    Article  PubMed  Google Scholar 

  42. Achem SR, Almansa C, Krishna M, et al. Eosinophilic oesophagitis in noncardiac chest pain: authors’ reply. Aliment Pharmacol Ther. 2011;34(1):110.

    Article  Google Scholar 

  43. Geagea A, Cellier C. Scope of drug-induced, infectious and allergic esophageal injury. Curr Opin Gastroenterol. 2008;24(4):496–501.

    Article  PubMed  Google Scholar 

  44. Clouse RE, Richter JE, Heading RC, Janssens J, Wilson JA. Functional esophageal disorders. Gut. 1999;45 Suppl 2:II31–6.

    Article  PubMed  Google Scholar 

  45. Mayer EA, Naliboff BD, Craig AD. Neuroimaging of the brain-gut axis: from basic understanding to treatment of functional GI disorders. Gastroenterology. 2006;131(6):1925–42.

    Article  PubMed  Google Scholar 

  46. Cannon 3rd RO. Causes of chest pain in patients with normal coronary angiograms: the eye of the beholder. Am J Cardiol. 1988;62(4):306–8.

    Article  PubMed  Google Scholar 

  47. Cannon 3rd RO, Cattau Jr EL, Yakshe PN, et al. Coronary flow reserve, esophageal motility, and chest pain in patients with angiographically normal coronary arteries. Am J Med. 1990;88(3):217–22.

    Article  PubMed  Google Scholar 

  48. Bennett J. ABC of the upper gastrointestinal tract. Oesophagus: Atypical chest pain and motility disorders. BMJ. 2001;323(7316):791–4.

    Article  PubMed  CAS  Google Scholar 

  49. Zachariae R, Melchiorsen H, Frobert O, Bjerring P, Bagger JP. Experimental pain and psychologic status of patients with chest pain with normal coronary arteries or ischemic heart disease. Am Heart J. 2001;142(1):63–71.

    Article  PubMed  CAS  Google Scholar 

  50. Deval E, Gasull X, Noel J, et al. Acid-sensing ion channels (ASICs): pharmacology and implication in pain. Pharmacol Ther. 2010;128(3):549–58.

    Article  PubMed  CAS  Google Scholar 

  51. Matthews PJ, Aziz Q, Facer P, Davis JB, Thompson DG, Anand P. Increased capsaicin receptor TRPV1 nerve fibres in the inflamed human oesophagus. Eur J Gastroenterol Hepatol. 2004;16(9):897–902.

    Article  PubMed  CAS  Google Scholar 

  52. Chauhan A, Petch MC, Schofield PM. Cardio-oesophageal reflex in humans as a mechanism for “linked angina”. Eur Heart J. 1996;17(3):407–13.

    Article  PubMed  CAS  Google Scholar 

  53. Sarkar S, Hobson AR, Hughes A, et al. The prostaglandin E2 receptor-1 (EP-1) mediates acid-induced visceral pain hypersensitivity in humans. Gastroenterology. 2003;124(1):18–25.

    Article  PubMed  CAS  Google Scholar 

  54. Hobson AR, Aziz Q. Brain processing of esophageal sensation in health and disease. Gastroenterol Clin North Am. 2004;33(1):69–91.

    Article  PubMed  Google Scholar 

  55. Saito YA, Mitra N, Mayer EA. Genetic approaches to functional gastrointestinal disorders. Gastroenterology. 2010;138(4):1276–85.

    Article  PubMed  CAS  Google Scholar 

  56. Wang WH, Huang JQ, Zheng GF, et al. Is proton pump inhibitor testing an effective approach to diagnose gastroesophageal reflux disease in patients with noncardiac chest pain?: a meta-analysis. Arch Intern Med. 2005;165(11):1222–8.

    Article  PubMed  CAS  Google Scholar 

  57. Numans ME, Lau J, de Wit NJ, Bonis PA. Short-term treatment with proton-pump inhibitors as a test for gastroesophageal reflux disease: a meta-analysis of diagnostic test characteristics. Ann Intern Med. 2004;140(7):518–27.

    PubMed  CAS  Google Scholar 

  58. Borzecki AM, Pedrosa MC, Prashker MJ. Should noncardiac chest pain be treated empirically? A cost-effectiveness analysis. Arch Intern Med. 2000;160(6):844–52.

    Article  PubMed  CAS  Google Scholar 

  59. Ofman JJ, Gralnek IM, Udani J, Fennerty MB, Fass R. The cost-effectiveness of the omeprazole test in patients with noncardiac chest pain. Am J Med. 1999;107(3):219–27.

    Article  PubMed  CAS  Google Scholar 

  60. Fass R, Achem SR. Noncardiac chest pain: diagnostic evaluation. Dis Esophagus. 2012;25(2):89–101.

    Article  PubMed  CAS  Google Scholar 

  61. Pandolfino JE, Ghosh SK, Rice J, Clarke JO, Kwiatek MA, Kahrilas PJ. Classifying esophageal motility by pressure topography characteristics: a study of 400 patients and 75 controls. Am J Gastroenterol. 2008;103(1):27–37.

    Article  PubMed  Google Scholar 

  62. Gyawali CP, Kushnir VM. High-resolution manometric characteristics help differentiate types of distal esophageal obstruction in patients with peristalsis. Neurogastroenterol Motil. 2011;23(6):502-e197.

    Article  PubMed  Google Scholar 

  63. Pandolfino JE, Roman S, Carlson D, et al. Distal esophageal spasm in high-resolution esophageal pressure topography: defining clinical phenotypes. Gastroenterology. 2011;141(2):469–75.

    Article  PubMed  Google Scholar 

  64. Roman S, Lin Z, Pandolfino JE, Kahrilas PJ. Distal contraction latency: a measure of propagation velocity optimized for esophageal pressure topography studies. Am J Gastroenterol. 2011;106(3):443–51.

    Article  PubMed  Google Scholar 

  65. Clouse RE, Lustman PJ, Eckert TC, Ferney DM, Griffith LS. Low-dose trazodone for symptomatic patients with esophageal contraction abnormalities. A double-blind, placebo-controlled trial. Gastroen­terology. 1987;92(4):1027–36.

    PubMed  CAS  Google Scholar 

  66. Hobson AR, Furlong PL, Sarkar S, et al. Neurophysiologic assessment of esophageal sensory processing in noncardiac chest pain. Gastroenterology. 2006;130(1):80–8.

    Article  PubMed  Google Scholar 

  67. Drewes AM, Reddy H, Pedersen J, Funch-Jensen P, Gregersen H, Arendt-Nielsen L. Multimodal pain stimulations in patients with grade B oesophagitis. Gut. 2006;55(7):926–32.

    Article  PubMed  CAS  Google Scholar 

  68. Serlie AW, Duivenvoorden HJ, Passchier J, ten Cate FJ, Deckers JW, Erdman RA. Empirical psychological modeling of chest pain: a comparative study. J Psychosom Res. 1996;40(6):625–35.

    Article  PubMed  CAS  Google Scholar 

  69. Kuijpers PM, Denollet J, Lousberg R, Wellens HJ, Crijns H, Honig A. Validity of the hospital anxiety and depression scale for use with patients with noncardiac chest pain. Psychosomatics. 2003;44(4):329–35.

    Article  PubMed  Google Scholar 

  70. Kuijpers PM, Denollet J, Wellens HJ, Crijns HM, Honig A. Noncardiac chest pain in the emergency department: the role of cardiac history, anxiety or depression and Type D personality. Eur J Cardiovasc Prev Rehabil. 2007;14(2):273–9.

    Article  PubMed  Google Scholar 

  71. White KS, McDonnell CJ, Gervino EV. Alexithymia and anxiety sensitivity in patients with non-cardiac chest pain. J Behav Ther Exp Psychiatry. 2011;42(4):432–9.

    Article  PubMed  Google Scholar 

  72. Huffman JC, Pollack MH. Predicting panic disorder among patients with chest pain: an analysis of the literature. Psychosomatics. 2003;44(3):222–36.

    Article  PubMed  Google Scholar 

  73. Prakash C, Clouse RE. Long-term outcome from tricyclic antidepressant treatment of functional chest pain. Dig Dis Sci. 1999;44(12):2373–9.

    Article  PubMed  CAS  Google Scholar 

  74. Viazis N, Keyoglou A, Kanellopoulos AK, et al. Selective serotonin reuptake inhibitors for the treatment of hypersensitive esophagus: a randomized, double-blind, placebo-controlled study. Am J Gastroen­terol. 2012;107(11):1662–7.

    Article  PubMed  CAS  Google Scholar 

  75. Keefe FJ, Shelby RA, Somers TJ, et al. Effects of coping skills training and sertraline in patients with non-cardiac chest pain: a randomized controlled study. Pain. 2011;152(4):730–41.

    Article  PubMed  CAS  Google Scholar 

  76. Attal N, Cruccu G, Baron R, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010;17(9):1113–e88.

    Article  PubMed  CAS  Google Scholar 

  77. Pasricha PJ, Ravich WJ, Hendrix TR, Sostre S, Jones B, Kalloo AN. Intrasphincteric botulinum toxin for the treatment of achalasia. N Engl J Med. 1995;332(12):774–8.

    Article  PubMed  CAS  Google Scholar 

  78. Porter RF, Gyawali CP. Botulinum toxin injection in dysphagia syndromes with preserved esophageal peristalsis and incomplete lower esophageal sphincter relaxation. Neurogastroenterol Motil. 2011;23(2):139–44. e127–8.

    Article  PubMed  CAS  Google Scholar 

  79. Prakash C, Freedland KE, Chan MF, Clouse RE. Botulinum toxin injections for achalasia symptoms can approximate the short term efficacy of a single pneumatic dilation: a survival analysis approach. Am J Gastroenterol. 1999;94(2):328–33.

    Article  PubMed  CAS  Google Scholar 

  80. Rao SS, Mudipalli RS, Mujica V, Utech CL, Zhao X, Conklin JL. An open-label trial of theophylline for functional chest pain. Dig Dis Sci. 2002;47(12):2763–8.

    Article  PubMed  CAS  Google Scholar 

  81. Rao SS, Mudipalli RS, Remes-Troche JM, Utech CL, Zimmerman B. Theophylline improves esophageal chest pain–a randomized, placebo-controlled study. Am J Gastroenterol. 2007;102(5):930–8.

    Article  PubMed  CAS  Google Scholar 

  82. Achem SR. New frontiers for the treatment of noncardiac chest pain: the adenosine receptors. Am J Gastroenterol. 2007;102(5):939–41.

    Article  PubMed  CAS  Google Scholar 

  83. Macpherson H, Dumville JC. Acupuncture as a potential treatment for non-cardiac chest pain – a survey. Acupunct Med. 2007;25(1–2):18–21.

    Article  PubMed  Google Scholar 

  84. Kim W, Jeong MH, Ahn YK. Acupuncture for chest pain. Heart. 2004;90(9):1062.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Barnes-Jewish Hospital, Washington University School of Medicine, 8124 660, South Euclid Avenue, St. Louis, MO, 63110, USA

    Anisa Shaker MD & C. Prakash Gyawali MD, MRCP

Authors
  1. Anisa Shaker MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Prakash Gyawali MD, MRCP
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Prakash Gyawali MD, MRCP .

Editor information

Editors and Affiliations

  1. Medical School, Coronary Artery Disease, Research Group, St George's Hospital, Cranmer Terrace, London, SW17 0RE, United Kingdom

    Juan Carlos Kaski

  2. University of Sydney, Discipline of Surgery, The Whiteley-Martin Research Centre, Parker Street, Sydney, 2747, New South Wales, Australia

    Guy D. Eslick

  3. , Women's Heart Center, Cedars-Sinai Heart Institute, S. San Vicente Blvd 444, Los Angeles, 90048, USA

    C. Noel Bairey Merz

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Shaker, A., Gyawali, C.P. (2013). Esophageal Chest Pain. In: Kaski, J., Eslick, G., Bairey Merz, C. (eds) Chest Pain with Normal Coronary Arteries. Springer, London. https://doi.org/10.1007/978-1-4471-4838-8_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4838-8_3

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4837-1

  • Online ISBN: 978-1-4471-4838-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation