Gastrocardial syndrome( Remkheld's syndrome) is a symptomatic complex that provokes the development of pathological disorders from the digestive and cardiovascular systems.
The clinical picture of the disease resembles a heart attack. However, it is important to remember that Remkheld's syndrome is not a separate disease, therefore it requires an integrated approach to treatment.
The concept of
Pathology develops due to excessive excitation of the vagus nerve against the background of increased irritation of mechanoreceptors capable of responding to stretching, and chemoreceptors that perceive different chemical compounds. The listed receptors are located on the wall of the esophagus, stomach and intestines.
After the meal, the blood is redistributed, its inflow to the digestive organs is increased, while the blood supply of the myocardium decreases. As a result, there are signs of a heart attack.
Remkheld syndrome develops predominantly in the following groups of patients:
- Hypersthenics;
- Patients with abdominal obesity;
- Patients with severe flatulence, which leads to an increase in intra-abdominal pressure;
- People of the hysteroid type who have an easily excitable nervous system.
Symptoms of the Remkheld syndrome
The pathological symptom complex occurs in patients after eating. Thus the symptomatology can be conditionally divided into such groups:
- Cardiological symptoms. Patients report a heart rhythm disturbance, a change in heart rate( possibly development of tachycardia, bradycardia, extrasystole), increased blood pressure, dizziness. The face becomes pale, a cold sweat appears. Characteristic is the development of the pain syndrome behind the sternum( pain can be pressing, aching, burning or paroxysmal).The duration of pain can vary from a few minutes to 2-3 hours.
- Gastroenterological signs. Severe flatulence, there are signs of damage to the gastric mucosa, which provokes the development of gastritis, stomach ulcers or erosion of the esophagus.
During the attack, patients note a lack of air and the appearance of fear of death. The person's face acquires a painful expression. Characteristic is the disappearance of symptoms after vomiting or strong eructation.
Diagnosis
Diagnosis of the syndrome of Remkheld is difficult, because the clinical manifestations of the gastrocardial complex resembles ischemic heart disease.
Therefore, patients need to carry out a complex of diagnostic activities:
- Inspection and collection of anamnesis. The doctor should ask the patient about the frequency of seizures, the reason for their development. It is necessary to record the presence of signs of obesity, to find out about the accompanying pathologies of the digestive tract;
- ECG.The study makes it possible to exclude the development of ischemic heart disease. However, during an attack, heart rate abnormalities often develop;
- Computed tomography or X-ray examination with contrast. Allow to determine the presence of a hernia in the area of the esophageal opening of the diaphragm;
- ultrasound of the digestive organs. The study will eliminate the pathology of the liver and pancreas;
- Respiratory urease test. The procedure is performed to determine the peptic ulcer.
Treatment of gastrodecardial syndrome
Patients with Remkheld syndrome require complex therapy. It is important to normalize the patient's diet, adhering to the basic rule - do not overeat. Therefore, it is recommended to reduce the size of portions by dividing the daily rate by 5-6 meals.
It is necessary to completely exclude from the diet fried, sharp and fatty dishes, to refuse alcohol and carbonated drinks. It will be necessary to limit the intake of chemical coarse food and products that irritate the intestines and stomach. Preference should be given to fruit and vegetables, fortified with fiber.
Medication therapy involves the use of the following drugs:
- Spasmolytics. Widely used Papaverin, Drotaverin. Preparations recommend taking 20-30 minutes before meals for the prevention of seizures;
- Sedatives( Motherwort extract, Persen);
- Proton pump inhibitors, bismuth preparations, antibiotics are used when stomach ulcers are detected in order to kill Helicobacter pylori;
- Prokinetics, antacid drugs are prescribed for patients with gastro-cardial syndrome developed against a background of reflux esophageal disease.
- Cardiac preparations. Before using medicines, a cardiologist is required.
If the patient is suffering from obesity, it is important to reduce the caloric content of meals, start playing sports. If the patient with Remkheld's syndrome does not have organic causes for the development of pathology, then treatment is recommended for the therapist.
Surgical intervention is indicated in the absence of the effect of conservative treatment or increased frequency and intensity of attacks.
During surgery, the surgeon sutures hernial gates, fixes the stomach or strengthens the esophagus-diaphragm ligament.
Forecast
Remkheld syndrome has a favorable prognosis. Drug therapy can effectively correct pathology.
Elimination of the organic cause of the disease leads to complete cure. If the gastrocardial syndrome has arisen as a result of autonomic dysfunction, then the therapy is effective for the therapist.
Ignoring the first signs of pathology can lead to the development of dangerous consequences.