Preliminary experience with the combined use of 24 pH-metering and Holter ECG monitoring in the differential diagnosis of angina-like-pain (ALP) is reported. Twenty patients aged 24-65 (15 females and 5 males) all with angina-like-pain were studied. The aim of the study was to differentiate between oesophageal and cardiac causes of the various types of chest pain and to investigate the possibility of their coexistence. 50% of the ALP patients with a negative non-invasive cardiological report presented a pathological gastroesophageal reflux. In 5% of the cases simultaneous coronary insufficiency and pathological gastro-oesophageal reflux was noted. The importance of performing both Holter recordings and pH-metering before subjecting patients to coronarography is therefore emphasised.