Angina-like non-cardiac chest pain of esophageal origin was proposed by Hippocrates. For many years the concept of “esophageal spasm” has held its place in the medical literature although documenting consistent esophageal motility disorders in these patients has been difficult. Recent work by Richter et al has demonstrated that up to 50% of patients with anginal-like chest pain and negative cardiac catheterizations in fact have GE reflux disease, and certainly a trial of proton pump inhibitor therapy is warranted in patients with anginal-like pain and negative cardiac workups.
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