GERD Can Mimic Symptoms of a Heart Attack

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The symptoms of gastroesophageal reflux disease (GERD) and esophageal spasm are often mistaken for angina, especially in women; and as a result, many are prescribed unnecessary, lifelong heart drug therapy. The crushing chest pain of angina is the result of restricted blood flow to the heart due to narrowed coronary arteries. People with angina are at a higher risk of having a heart attack. But for a significant number of women diagnosed with this condition, the chest pain is caused by GERD or spasms of the esophagus.

In 1996, British researchers estimated that one-third of women diagnosed with angina are given the wrong diagnosis. The problem is so widespread, they noted, that the European Society of Cardiology has issued guidelines warning doctors to take special care when diagnosing women. The next step in the diagnostic process usually clouds the issue further. The exercise tolerance test, which measures heart rate and breathlessness, has a high rate of false alarms in women.

That misdiagnosis of chest pain is more common in women was illustrated in a study of 886 people with chest pain who had been referred to angiography. This x-ray examination of the coronary arteries showed that 83 of 202 women had normal results. Of the 584 men in the study, 55 had normal coronary arteries (British Medical Journal, 4/2/94). Unfortunately, angiography is the only diagnostic procedure that can rule out angina.

Angiography's small risk of death must be weighed against the risks of taking lifelong unnecessary drugs for angina. The drugs usually prescribed for angina, include aspirin, nitrates, beta-blockers, and calcium channel blockers.

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