Services Institute of Medical Sciences, Lahore, Pakistan.
Army Medical College, Rawalpindi, Pakistan.
Herz. 2024 Dec;49(6):448-455. doi: 10.1007/s00059-024-05249-y. Epub 2024 May 7.
Roemheld syndrome (RS) is a condition that triggers cardiac symptoms due to gastrointestinal compression of the heart. It is often misdiagnosed as other types of cardiac or digestive disorders, leading to unnecessary treatments and reduced quality of life. Here, we provide a thorough review of RS, covering its pathogenesis, etiology, diagnosis, treatment, and outcome. We found that a number of conditions, including gallstones, hiatal hernia, excessive gas, and gastroesophageal reflux syndrome, can cause RS. The symptoms of RS can include chest pain, palpitations, shortness of breath, nausea, vomiting, bloating, and abdominal pain. Clinical history, physical examination, electrocardiograms, and improvement in symptoms following gastrointestinal therapy can all be used to identify RS. We also propose a set of criteria, the IKMAIR criteria, to improve the diagnostic approach for this condition. Dietary changes, lifestyle adjustments, pharmaceutical therapies, and surgical procedures can all be used to control RS. Depending on the underlying etiology and the outcome of treatment, RS has a varying prognosis. We conclude that RS is a complicated and understudied disorder that needs more attention from researchers and patients as well as from medical professionals. We recommend the inclusion of RS in the differential diagnosis for individuals with gastrointestinal problems and unexplained cardiac symptoms. Additionally, we advise treating RS holistically by attending to its cardiac and gastrointestinal components.
罗梅勒德综合征(RS)是一种由于胃肠道压迫心脏而引发心脏症状的疾病。它经常被误诊为其他类型的心脏或消化系统疾病,导致不必要的治疗和生活质量下降。在这里,我们对 RS 进行了全面的回顾,涵盖了其发病机制、病因、诊断、治疗和预后。我们发现,许多情况,包括胆结石、食管裂孔疝、过多气体和胃食管反流综合征,都可能导致 RS。RS 的症状包括胸痛、心悸、呼吸急促、恶心、呕吐、腹胀和腹痛。临床病史、体格检查、心电图以及胃肠道治疗后症状的改善都可用于识别 RS。我们还提出了一套 IKMAIR 标准,以改善对这种疾病的诊断方法。饮食改变、生活方式调整、药物治疗和手术都可用于控制 RS。RS 的预后因潜在病因和治疗结果而异。我们的结论是,RS 是一种复杂且研究不足的疾病,需要研究人员、患者以及医疗专业人员给予更多关注。我们建议将 RS 纳入有胃肠道问题和不明原因心脏症状的个体的鉴别诊断中。此外,我们建议通过关注其心脏和胃肠道成分来对 RS 进行全面治疗。