Roemheld's Syndrome ( RS ), also known as Roemheld-Techlenburg-Ceconi-Syndrome or gastric-cardia , is complex gastrocardiac symptoms were first described by Ludwig von Roemheld (1871-1938). This is a syndrome in which diseases of the gastrointestinal tract or stomach are found to be associated with cardiac symptoms such as arrhythmias and benign palpitations. There is rarely a traceable heart source that can cause a long period of misdiagnosis.
Video Roemheld syndrome
Symptoms
Symptoms can be as follows. They are periodic, and occur only during "episodes," usually after meals.
- Sinus bradycardia
- Difficulty breathing
- Angina pectoris
- Left ventricular discomfort
- Fatigue
- Anxiety
- Uncomfortable breath
- Bad perfusion
- Muscle aches (cramps)
- Burst or vertigo is ongoing or dizzy
- Sleep disturbance (especially when sleeping within a few hours of eating, or lying on the left side)
- Extrasystoles
- Hot flashes
Mechanical
The mechanically induced hospital is characterized by pressure in the left epochastric and hypochondrial regions. Often the pressure is on the fundus of the stomach, esophagus or intestinal distention. It is believed to cause increased diaphragm, and secondary cardiac displacement. It reduces the heart's ability to replenish and increase cardiac contractility to maintain homeostasis.
Neurological
Changes in mechanical function of the shell of the intestine can suppress the vagus nerve in a number of locations along the vagus, slowing the heart. When the heart slows, the autonomic reflex is triggered to increase blood pressure and heart rate.
It is equipped with a gastro-coronary reflex in which the coronary artery narrows with "functional cardiovascular symptoms" similar to chest pain on the left side and radiation to the left shoulder, dyspnea, sweating, angina pectoris attacks such as with extrasysts, decreased blood pressure, and tachycardia ( high heart rate) or sinus bradycardia (heart rate below 60). Typically, no associated changes/abnormalities in the ECG are detected. It can actually trigger heart attacks for people with structural heart abnormalities ie coronary bridge, coronary loss, and atherosclerosis.
If the heart rate drops too low for too long, catecholamines are released to counteract the drop in blood pressure. Catecholamines bind to alpha receptors and beta receptors, decrease vasodilation and increase cardiac contractility. Maintaining this condition causes fatigue of the liver which causes fatigue and chest pain.
Maps Roemheld syndrome
Cause
- Gastroesophageal reflux disease
- Excessive gas in the transverse colon caused by:
- Lactose intolerance
- abnormal gall bladder function and/or blood flow
- Gallstones
- Oddi dysfunction splitter
- Hiatal hernia
- The heart of the bridge (Ocular coronary reflex triggered by coronary reflex)
- Enteric disease
- Aneructonia, loss of ability to burp (continuous or intermittent)
- Bowel obstruction (Less common, usually causes severe pain in a short time)
- Acute pancreatic necrosis
Because gas is the usual trigger, eating a person's intolerant food can make the symptoms worse.
Diagnosis
There is significant hospital misdiagnosis scope. The diagnosis of the hospital usually begins with a heart examination, because the symptoms of the stomach can escape the attention, heart symptoms are scary and can be very severe. After EKG, Holter monitors, slope tests, cardiac MRI, cardiac CT, cardiac catheterization, EP studies, echo-cardiogram, and extensive blood work, and possibly sleep studies, cardiologists may rule out heart conditions.
Often a psychological examination may occur because a conversion disorder can be suspected in the absence of heart disease, or structural heart abnormalities.
Diagnosis is often made on the basis of symptoms without any cardiac abnormalities. A gastroenterologist will perform colonoscopy, endoscopy, and ultrasound to find or eliminate problems in the stomach.
Determining the cause of Roemheld's syndrome is still not an exact science. If you have an ultrasound or sleep study, make sure you know how to reproduce the symptoms, as it is difficult to detect abnormalities when the symptoms subside.
Therapy
Treatment of primary gastroenterological distress is the first concern, gastric mitigation of the stomach will also relieve heart problems.
- An anticholinergic, magnesium, or sodium supplement (to raise blood pressure)
- Anticonvulsants have eliminated all symptoms in some hospital patients; Lorazepam, Oxcarbazepine increases GI motility, reduces vagus "noise" (sodium channel blockage is believed to contribute to positive effects)
- Alpha blockers can increase motility if gi is a problem, also 5 mg to 10 mg amitriptyline if motility is a problem that can not be solved by another method
- antigas - simetikon, beano, omnimax reduces epigastric pressure
- Antacids - nexium, tums, Pepcid AC, rolaids, etc. reducing acid reflux in cases of hiatal hernia or other esophageal esophageal type.
- Vagusectomy Beta blockers - reduces cardiac contractility and autoactivity that reduces irregular rhythm but also lowers blood pressure when symptoms occur, and further reduces perfusion ex: Atenolol, this will control disarhythmia, but can precipitate Prinzmetal Angina and Heart block substantially./li>
History
Ludwig Roemheld marked this particular syndrome shortly before his death; One of his research topics today is the effect of calorie intake on the heart. At Elsevier, there is no current research or publication under the name Roemheld syndrome, and as a result many cases are undiagnosed. German publications on the subject remain untranslated in 2009.
Epidemiology
Roemheld's syndrome is marked strictly by a stomach illness that triggers a reflex in the heart. There are a number of pathways through which cardiac reflexes can occur: hormonal, mechanical, neurological and immunological.
See also
- Sync swallow
References
Source of the article : Wikipedia
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