A false positive of heart diseases – the Roemheld syndrome
It has become evident in our modern times, that many of our lifestyle habits, in particular keeping up with our increasingly hectic society, are taking their toll on our health. Our work-life balance is skewed heavily towards stress and our nutritional preferences are dictated by the time available to cook and the income to spare. It is therefore not surprising that our health is impacted negatively by how we conduct our life and manage our care. Such factors lead to the creation of ever new ‘life-style’ ailments that we succumb to, and are very frequently misdiagnosed for what they are not and are as a consequence not seldom inappropriately treated. One such ‘modern’ disease, that likely has some of its causative factors in our life-style and nutritional habits, is undoubtedly the ‘Roemheld syndrome’.
This symptom complex of ‘gastric cardia’ was first identified and described as a stand-alone syndrome in the early 1930’s, when Dr. Ludwig Roemheld identified the reflex heart symptomatology specifically caused by gastro-intestinal discomforts. Characterized by symptoms mimicking those of angina pectoris, the Roemheld syndrome is often mistaken for the former. As such the following afflictions are common to ‘RS’: Palpitation, arrhythmia (tachycardia), circulatory disorders, dizziness, dyspnea, and related states of fear and anxiety, panic attacks. Further symptoms associated with ‘RS’ are: Gastro-intestinal discomforts, trapped gas, nausea, hot flashes, sleep-disorders, syncope and tinnitus.
Ultimately the cause of the ‘syndrome’ is the development of gas in the digestive tract. This may be of varied origin and besides mal-nutrition, food-intolerance, indigestion, speaking while chewing and as such ‘swallowing’ air, may be caused by life-style factors such as stress, anger, or depression. Our sedentary work practice may play a role. We are accustomed to conduct most of our work sitting down, we engage in little physical exercise, eat rapidly and unhealthily, sooner or later such habits must make us ill. However there are also disease factors that promote Roemheld syndrome. IBS, irritable bowel syndrome, has been named as a potential adjunctive cause of ‘RS’, as has the existence of a hiatus hernia. Neural involvement of the vagus nerve has also been linked to the development of the ‘RS’ symptomatology. In this case sensory communication from the digestive tract to the brain is believed to impact the development of symptoms.
During an ‘attack’, the bloated gastro-intestinal tract displaces the organs in the thoracic cavity. To the patient there appears to be insufficient space in the chest. The bloated stomach and bowels push the lungs aside, generating pressure on the heart, causing anxiety, difficulty breathing, oppression, weakness, dizziness and faintness in the patient. The pulse rate increases, palpitation may appear and arrhythmia are triggered, in the form of tachycardia or extra systoles. It is not infrequent that these symptoms take a patient to see a cardiologist. However the causative factors of the presenting symptoms are often misinterpreted as originating from the heart itself.
In many cases the management of ‘RS’ can be achieved by altering dietary and lifestyle habits. As such, avoiding certain foods can alleviate symptoms and prevent ‘attacks’. Reducing alcohol and restricting the consumption of fizzy drinks, which promote fermentation in the bowels and thereby produce gas, can be helpful. Fast food, fatty meals, vegetables such as of the onion family, cabbage, pulses, pastry, and particularly white flour products should be avoided; such changes sooth the digestive activity of the stomach and bowels. However surgical intervention may be necessary where a hiatus hernia is identified as causative factor.
Conventional medicine suggests the administration of medication that reduces bloating, and inhibits the development of gas in the digestive tract. Yet this medical intervention is one that only palliates and does not remove the underlying cause. The issue remains and drug side-effects can produce consequential troubles in the long run. Acute alleviation can be achieved by herbal tea infusions with fennel, melissa, mint, juniper or black cumin. From a homeopathic perspective, remedies that aim at the removal of the digestive pathology and take into consideration the patient idiosyncratic cardiac symptomatology should be considered (gastro-cardia symptom complex).