Manometric Evaluation of Esophageal Motility in Patients With Non-cardiac Chest Pain: A Retrospective Study From a Tertiary Center in Abu Dhabi, United Arab Emirates

Non-cardiac chest pain (NCCP) is a frequent clinical problem that often mandates intensive investigations for the exclusion of cardiac etiology. Esophageal motility disorders are a leading cause of NCCP; however, data from the Middle East are lacking. This was a retrospective study of 41 male patients (n=41; 100%) aged 23-57 years, who were referred to a tertiary care institution in Abu Dhabi, United Arab Emirates, with NCCP. All patients had high-resolution manometry (HRM), upper gastrointestinal endoscopy, and laboratory testing. HRM showed ineffective esophageal motility (IEM) as the most common abnormality in 12 patients (n=12; 30%), followed by distal esophageal spasm (DES) in five patients (n=5; 12.5%), while achalasia and esophagogastric junction (EGJ) outflow obstruction were infrequent. Importantly, 18 patients (n=18; 45%) with routine endoscopy had abnormal HRM patterns, reflecting the shortcomings of endoscopy alone. We did not find a significant correlation between endoscopic and HRM findings. These findings support the importance of including HRM in NCCP diagnostic algorithms to enhance accuracy and inform personalized, patient-centered management in this area.