Background: The cause of chest discomfort in patients with primary mi­tral valve prolapse (MVP) remains un­known.
Aim: our aim was to determine prospectively the incidence of esoph-ageal disorders and abnormal re­sponses to esophageal acid infusions in patients with primary MVP with and without chest pain,
Patients and Methods: 28 patients with primary MVP diagnosed by echo-cardiography underwent esophageal motility study and provocative testing with acid infusion. Ten healthy sub­jects served as control group; they also underwent the same studies.
Results: Esophageal manometry revealed esophageal disorders in 14
patients: diffuse esophageal spasm in 9 patients, hypotensive lower esopha­geal sphincter (LES) in 4, hyperten­sive LES in 3, nonspecific motor dis­orders in 2 and no patient with nutcracker esophagus. Acid infusion tests (Bernstein tests) evoked typical chest discomfort in 11 of 28; most of them were in group 111 with severe MVP, on the other hand, acid infusion test evoked chest discomfort in only one of 10 control subjects.
Conclusion: Esophageal disorders were common and may account for chest discomfort in some patients with primary MVP and persistent chest pain syndromes.