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August 8, 1977

Partial Relief of Anginal Chest Pain by Belching

JAMA. 1977;238(6):481. doi:10.1001/jama.1977.03280060025010

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To the Editor.—  As a staff member on an academic cardiology service, I see several patients each year with documented coronary artery disease (at least 70% obstruction of at least one major vessel by coronary arteriography) and typical angina pectoris; they obtain partial relief of their anginal discomfort by belching. The mechanism of this is unclear but could, at least in part, reflect the following sequence of events: angina → anxiety → air swallowing → gastric distension → sensation of lower thoracic discomfort → partial relief after belching.The purpose of this communication is to emphasize that partial relief by belching should not be interpreted as strong evidence against an ischemic origin for chest discomfort that is otherwise suggestive of angina pectoris.