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The Korean Journal of Medicine 2009;77(2): 187-192.
관상동맥조영술이 정상인 비심인성 흉통 환자의 상부위장관내시경 소견
이명하, 박영숙, 김남인, 정준영, 송은주, 조윤주, 김성환, 전대원, 최재웅, 유승기, 조용범
The endoscopic findings in patients with noncardiac chest pain who have a normal coronary angiogram
Myoung Ha Lee, Young Sook Park, Nam In Kim, Jun Young Jung, Eun Ju Song, Yun Ju Jo, Seong Hwan Kim, Dae Won Jun, Jae Ung Choe, Seung Gi Yu, Yong Beom Jo
Noncardiac chest pain (NCCP) mainly results from esophageal lesions in the developed world. By contrast, gastroesophageal reflux disease (GERD) is a less frequent cause of NCCP than peptic ulcer disease in China and Japan. Therefore, both esophageal lesions and stomach and duodenal lesions are likely to be important causes of NCCP in Korea. We used upper gastrointestinal endoscopy to evaluate lesions of the esophagus, stomach, and duodenum in NCCP patients after cardiac chest pain was ruled out by coronary angiography (CAG).
From the patients who underwent CAG between 2004 and 2008, we identified 89 patients who had normal CAG or minimal disease. We retrospectively analyzed the endoscopic findings of these 89 patients who were diagnosed with NCCP.
At endoscopy for the 89 patients, the percentages of GERD, gastric ulcer, and duodenal ulcer were 20.2% (n=18), 14.6% (n=13), and 3.3% (n=3) respectively. Of the 16 cases diagnosed as peptic ulcer, 11 were evaluated by biopsy or the Campylobacter-like organism (CLO) test for suspected Helicobacter pylori infection. Six (54%) cases were positive for H. pylori and five (46%) were negative.
In Korea, the incidence of peptic ulcer disease (17.9%) as a cause of NCCP is similar to that of GERD (20.2%). Consequently, we should perform endoscopy to determine the cause of NCCP. (Korean J Med 77:187-192, 2009)
Keywords: Noncardiac chest pain; Endoscopy; Coronary angiography
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