Useful triad for diagnosing the cause of chest pain.

In a series of 127 consecutive patients operated on for thoracic outlet syndrome and 100 consecutive patients who had antireflux operations for reflux esophagitis, we found a high incidence of association between thoracic outlet syndrome, reflux esophagitis, and cardiovascular disease. In the group of patients with thoracic outlet syndrome, 35.4% had reflux esophagitis and 26%, cardiovascular disease. Of the patients operated on for reflux esophagitis, 38% were found to also have thoracic outlet syndrome and 39%, cardiovascular disease. While cardiovascular diseases have by far the most serious consequences for patients with chest pain, the high incidence of association between cardiovascular diseases, reflux esophagitis, and thoracic outlet syndrome comprises a triad helpful for the etiologic diagnosis of chest pain.