Introduction: The oesophagus can be a mimic of cardiac pain. It is assessed that pathological reflux is responsible for about 20 to 60 % of NCCP.

The aim of this study was to evaluate differences in 24-hour pH-metry and OT in patients with NCCP and coronary artery disease (CAD), syndrome X and GERD.

Material and methods: 27 patients, mean age 49.2 +/- 11 with diagnosed GERD were involved in the study. They were divided into 3 groups: 1: 10 patients with no coronary artery disease, 2: 7 patients with false positive exercise test and normal arteries on angiography, 3: 10 patients with CAD. All the patients underwent pH-metry and OT (40 mg AM and 20 mg PM) for a week. The sensitivity of symptoms was assessed at the baseline and after performing OT.

Results: There were no significant differences in total time with pH < 4.0. However in the group 2 the total time with pH < 4.0 in upright position was significantly higher (group 1: 14.1 +/- 10 %; group 2: 25 +/- 9 %, group 3: 11.2 +/- 9.3 %). There were also remarkable differences in number of prolonged reflux episodes: group 1: 5.2 +/- 4.8, group 2: 9.3 +/- 7.1, group 3: 5.5 +/- 5.2. Reflux symptom index was above 50 % in 10 patients (100 %) in the group 1, in 4 patients (57 %) in the group 2 and in 2 patients (25 %) in the group 3. PPI treatment caused a significant improvement in 9 patients (90 %) in the group 1, in 6 patients (86 %) in the group 2 and in 6 patients (60 %) in the group 3.

Conclusions: In patients with false positive exercise test and normal coronary arteries on angiography reflux in upright position as well prolonged reflux episodes are more frequently observed. PPI are effective method of treatment for patients with GERD and NCCP, however in patients with CAD probably due to overlap only 60 % of patients report a relief.

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