Central chest pain can be caused by coronary heart disease, and by oesophageal diseases. The symtoms may be quite similar, and the differential diagnosis is not easy. Chest pain due to reflux oesophagitis can get worse during physical excercise.
Chest pain due to heart disease indicates a potentially dangerous situation. Reflux oesophagitis is troublesome but the mortality is nearly nil. These pictures show a reflux oesophagitis that caused symtoms very similar to angina seen in coronary artery disease. To the right a part of a normal ECG is seen.
Reflux oesophagitis is the most common cause of oesophageal pain. Achalasia, diffuse spasm and other motility abnomalities can cause oesophageal chest pain.
All patients with suspected coronary heart disease, where the diagnose is not firm, should probably have an endoscopy done, in order to rule out easily treated oesophageal diseases like this reflux oesophagitis.
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