Important message for us all, Roemheld syndrome

Roemheld syndrome

RS also known as Roemheld-Techlenburg-Ceconi-Syndrome or Gastric-cardia, is acomplex of gastro cardiac symptoms first described by Ludwig Roemheld (1871 – 1938).

It is a syndrome where maladies in the gastrointestinal tract or abdomen trigger/cause cardiac symptoms. There is rarely a traceable cardiac source to the symptoms which may lead to a lengthy period of misdiagnosis.
Epidemology Roemheld syndrome is characterized strictly by abdominal maladies triggering reflexes in the heart. There are a number of pathways through which cardiac reflexes can occur: hormones, mechanical, neurological and immunological.
Mechanical
Mechanically induced RS is characterized by pressure in the epigastric and left hypochondriac region. Often the pressure is in the fund us of the stomach, esophagus or distention of the bowel. It is believed this leads to elevation of the diaphragm, and secondary displacement of the heart. This reduces the hearts ability to fill and increases the contractility of the heart to maintain homeostasis.
Neurological
The mechanical changes in the gut can compress the vagus nerve at any number of locations along the vagus, slowing the heart. As the heart slows, autonomic reflexes are triggered to increase blood pressure and heart rate. This is complemented by gastro-coronary reflexes whereby the coronary arteries constrict with "functional cardiovascular symptoms" similar to chest-pain on the left side and irradiation to the left shoulder, dyspnea, sweating, up to angina pectoris -like attacks with extra systoles, drop of blood pressure, and tachycardia (high heartbeat) or sinus brady-cardia (heart beat below 60). Typically, there are no changes / abnormalities related in the EKG detected. This can actually trigger a heart attack for persons with cardiac structural abnormalities i.e. coronary bridge, missing coronary, and atherosclerosis. If the heart rate drops too low for too long, catecholamines are released to counteract any lowering of blood pressure. Catecholamines bind to alpha receptors and beta receptors, decreasing vasodilation and increasing contractility of the heart. Sustaining this state causes heart fatigue which results in fatigue and chest pain.
History
Ludwig Roemheld characterized this particular syndrome shortly before his death; one of his research topics around this time was the effects of calorie intake on the heart. In Elsevier, there is no current research or publishing under the name Roemheld syndrome, and as a result many cases go undiagnosed. German publishing on the subjectremains untranslated as of 2009.
Symptoms
Symptoms are periodic, and occur only during an "episode" usually after eating.


I'm going to my doctor and finding out how I can be tested for this, I have most if not all these symptoms.

Your Friend,

James

8 Comments

Roemheld syndrome

by Juan - 2011-12-23 01:12:03

James,
Are you telling us that we should be careful and not eat too much at one sitting during the holidays?
Juan

RS

by Blue - 2011-12-23 11:12:06

At my last cardio checkup I told my sp that I get this weird feeling down the centre of my chest . He said that my symptoms were related to digestive troubles and in short, said it was not really known just how much it reflected on the heart. I found your piece on Rs really interesting. Since seeing the cardio I have had surgery for a digestive problem and my symptoms seem to have been alleviated. For this reason I was intrigued with your posting. I hope all goes well for you when you see your medicao. Have a Blessed Christmas and I wish you a Happy New Year. Sincerely Billie

Add this to the list

by ElectricFrank - 2011-12-25 02:12:51

Hypertension can occur locally in the body and not be measurable using the normal cuff method. The digestive system is supplied by the abdominal aorta which rapidly spreads into smaller vessels. Pressure on this large artery or its downstream system can cause a local hypertension that may not show on the typical cuff system of measurement. However, it does produce a greater back pressure on the heart and less elasticity to absorb the pulsed output. Hmm, could this be the source of some of the heavy thumping we feel?

Keep in mind that I am looking at this from the perspective of hydrolic engineering, not as a medical type.

more later,

frank

Frank

by Christmmpace - 2011-12-25 09:12:52

This is interesting wisdom my friend, something for us to think about indeed. Thanks

Frank

by Christmmpace - 2011-12-25 09:12:53

This is interesting wisdom my friend, something for us to think about indeed. Thanks

More

by ElectricFrank - 2011-12-26 12:12:44

I just got to thinking that an irritable heart might react to the back pressure of various organs being squeezed by the digestive system with various arrhythmia's.

One more vote for the body as an integrated system rather than a group of separate individual organs.

frank

Paroxismal Tachicardya and Roemheld Syndrom

by SoulHealer - 2012-01-02 04:01:13

I'm 62 years old and I'm facing for decades with extrasistoles and since last 2 years, with some episodes of AFib, Flutter or re-entry Paroxismal Tachicardia. The episods start after meals with some intake of alchool. I have Hiatal Hernia, Helicobacter Pylori, IBS, and a heart without structural abnormalities. Different cardiologist sugest an EP study and an ablation to eliminate cardiac arithmya no matters what are their rootcause. However, I think that I have an RS due to the cardiac simptoms are triggered by my GI problems directly through diafragm pressure against hipocondriac region or via vagus nerve hiperstmulation due to bowel gas acumulation. Last time, after 20 hours of atrial flutter an electric conversion was necessary to put me back in sinus rithm! What do you think? May I try a RS treatment before ablation?
Best regards,
SoulHealer

Hiatus hernia - "the great mimic"

by mutluturk - 2012-05-22 06:05:07

I am 38 and from time to time I got that wierd feeling down my chest area, I dont know what it is. It is like a palpitation but it is not, I was guessing it was just a digestion trouble. Then I came accros this post, it was the one that made me so reileved, and I often came back to read it. But know I found out the real reason, I urge you to read this link: http://en.wikipedia.org/wiki/Hiatal_hernia . And here is what it says:
Signs and symptoms:
Hiatal hernia has often been called the "great mimic" because its symptoms can resemble many disorders. For example, a person with this problem can experience dull pains in the chest, shortness of breath (caused by the hernia's effect on the diaphragm), heart palpitations (due to irritation of the vagus nerve), and swallowed food "balling up" and causing discomfort in lower esophagus until it passes on to stomach.

So take care everybody, and eat less and often.
Mutluturk!

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