RT-119
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Multiparametric
echocardiographic stress testing with oesophageal electrical stimulation and
trans-oesophageal cardiac pacing
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Paolo Rossi, Corrado Pozzi,
Stefano Ticozzi, Pierfranco Dellavesa.
Clinica "I Cedri", Fara Novarese (NO), Italy
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Introduction
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Identifying the cause of chest pain of unknown origin
may be difficult. Up to one quarter of patients admitted with acute chest pain prove to
have an alimentary cause1. In such patients, the
culprit oesophageal lesions involve either gastro-oesophageal reflux of acid, or motility
disorders eg diffuse oesophageal spasm, "nutcracker" oesphagus or both together.
Recently, the diagnostic overlap between cardiac and oesophageal chest pain has been
increased by the demonstration that exertion can produce gastro-oesophageal reflux of acid
not present at rest. Oesophageal pain may be exercise-induced, a relationship which
hitherto has been a cornerstone in the diagnosis of true cardiac angina2.
The aim of this study was to investigate the clinical value and diagnostic accuracy of new
technique on the evaluation of chest pain in patients that do not have clear evidence of
cardiac ischemia. The new technique is involved in the assessment of oesophageal pain
threshold by electrical oesophageal stimulation3.
Furthermore, the same oesophageal catheter has been used to achieve stress
echocardiography by performing a trans-oesophageal cardiac pacing.
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