GASTROCARDIAL SYNDROME

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GASTRO-KARDIALNYY SYNDROME (grech, gaster a stomach + kardia heart) — the complex of subjective and objective signs of disturbances of action of the heart (change of speed, a rhythm, a stethalgia, an asthma, changes on an ECG) which is observed after food, especially at overflow of a stomach and high standing of a diaphragm.

The Russian doctor F. K. Uden (1817) for the first time pointed to a functional linkage between a stomach and heart.

N. P. Simanovsky (1881) in I. P. Pavlov's laboratory showed that during the inflating of a stomach a barrel blood pressure increases and pulse urezhatsya. S. P. Botkin (1884) noted that it is necessary to distinguish those which are caused by a reflex from abdominal organs from various forms of angina pectoris. P. Poten also said that when the patient complains of heart, investigate a stomach. In 1912 - to. page it was described by L. Roemheld who considered it as a special form of so-called neurosises of heart; therefore this syndrome quite often call by his name.

Influence of food reflexes (conditional and unconditional), sham feeding, deglutitory movements, hungry motility of a stomach on cordial activity is in detail studied by generally domestic physiologists. Gastrocordial reflexes can arise not only from mechanioreceptors, but also from chemoceptors of a stomach (I. E. Ganelin). Changes of an ECG at irritation of interoretseptor of a gullet and stomach are observed even at healthy faces. At patients with the irritation of a stomach is hidden by the proceeding pathological process in a muscle of heart and coronary arteries can worsen a functional condition of a myocardium; at the same time sharper and permanent changes of an ECG are observed.

Thus, G.'s pathogeny - to. page rather difficult that leads to various interpretation of its essence. One authors describe its purely functional character; others, emphasizing that G. - to. the page evolves almost only from atherosclerosis of coronary vessels, carry this syndrome to coronary heart disease and apply this term to those cases when attacks of stenocardia and other cordial symptoms arise or amplify after meal (at the crowded stomach). From these positions cases of sudden death after plentiful meal find an explanation.

G.'s manifestations - to. pages are various: after food patients have pressure and pains in precordial area or behind a breast, a heart consciousness, change of heart rate in the form of tachycardia or, on the contrary, bradycardia, sometimes — disturbance of a rhythm in the form of premature ventricular contraction; dizzinesses and fluctuations of level of arterial pressure are observed; the eructation usually facilitates this state.

To G.'s emergence - k.s. errors in food, a meteorism, high standing of a diaphragm, especially at the persons having obesity and also functional disorders of the autonomic nervous system promote. - to. the page can be one of manifestations of coronary insufficiency, option of reflex stenocardia, usually in the presence of coronary atherosclerosis.

At differential diagnosis it must be kept in mind similar clinical manifestations at an ulcer or a carcinoma of the stomach, especially at their localization in cardial department of a stomach, hernia of an esophageal opening of a diaphragm.

At G. - to. pages are applied sedative and vegetotropny means. Treatment of coronary insufficiency, restriction of volume of food at its frequent reception is carried out; an exception of the products causing mechanical and chemical irritation of a stomach and fight against a meteorism; also normalization of work of intestines is important. It is necessary to avoid a research of a stomach the probe and gastroscopies.


Bibliography: Botkin S. P. Course of clinic of internal diseases and clinical lectures, t. 2, page 491, M., 1950; Ganelina I. E. Interoceptive influences from digestive tract on heart, M. — L., 1963, bibliogr.; At d e of N of F. K. The academic readings about chronic diseases, t. 4, page 269, SPb., 1817; Fedorov B. M. About influence of an instinctive food reflex on a rhythm of cordial activity in the conditions of pathology, Bulletin Ekspery, biol, and medical, t. 51, No. 5, page 33, 1961; Hegglin R. Differential diagnosis of internal diseases, a per, with it., page 327, M., 1965; Roemheld L. Der gastro-kardiale Symptomenkomplex, eine besondere Form sogenannter Herzneu-rose, Z.phys. diatet. Ther., Bd 16, S. 339, 1912.

G. I. Burchinsky.

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