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Exploring Roemheld syndrome: a comprehensive review with proposed diagnostic criteria

Untersuchung des Roemheld-Syndroms: eine umfassende Übersicht mit einem Vorschlag für Diagnosekriterien

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Abstract

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.

Zusammenfassung

Das Roemheld-Syndrom (RS) ist eine Erkrankung, die kardiale Symptome durch eine gastrointestinale Kompression des Herzens auslöst. Häufig wird es als andere Arten von Erkrankungen des Herzens oder des Verdauungstrakts verkannt, was zu unnötigen Behandlungen und einer verminderten Lebensqualität führt. Im vorliegenden Beitrag wird eine umfassende Übersicht über das RS gegeben, einschließlich Pathogenese, Ätiologie, Diagnose, Therapie und Verlauf. Die Autoren stellten fest, dass eine Reihe von Erkrankungen, wie Gallensteine, Hiatushernie, ausgeprägte Blähungen und gastroösophageales Refluxsyndrom, ein RS verursachen können. Zu den Symptomen des RS können Schmerzen in der Brust, Palpitationen, Kurzatmigkeit, Übelkeit, Erbrechen, Blähungen und Bauchschmerzen gehören. Zur Feststellung eines RS eignen sich die klinische Anamnese, körperliche Untersuchung, EKG und eine Symptomlinderung nach gastrointestinaler Therapie. Die Autoren schlagen auch eine Reihe von Kriterien vor, die IKMAIR-Kriterien, um den diagnostischen Ansatz bei dieser Erkrankung zu verbessern. Veränderungen bei der Ernährung, in der Lebensweise, medikamentöse Therapien und chirurgische Eingriffe können zur Beherrschung des RS eingesetzt werden. Je nach zugrunde liegender Ätiologie und Ergebnis der Behandlung weist das RS eine unterschiedlich Prognose auf. Die Autoren kommen zu dem Schluss, dass RS eine komplizierte und zu wenig erforschte Erkrankung ist, die mehr Aufmerksamkeit von Wissenschaftlern und Patienten sowie von Ärzten benötigt. Sie empfehlen bei Personen mit gastrointestinalen Beschwerden und unerklärlichen kardialen Symptomen die Einbeziehung von RS in die Differenzialdiagnose. Darüber hinaus raten sie dazu, das RS ganzheitlich zu behandeln, indem auch die kardialen gastrointestinalen Komponenten berücksichtigt werden.

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Authors and Affiliations

  1. Services Institute of Medical Sciences, Lahore, Pakistan

    Muhammad Umair Javaid,  Muhammad Ikrama,  Shafqat Abbas,  Muhammad Danial Khalid,  Nabeel Riaz &  Malik Ahsan Safdar

  2. Army Medical College, Rawalpindi, Pakistan

    Muhammad Saad Javaid

Authors
  1. Muhammad Umair Javaid
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  2. Muhammad Ikrama
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  3. Shafqat Abbas
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  4. Muhammad Saad Javaid
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  5. Muhammad Danial Khalid
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  6. Nabeel Riaz
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  7. Malik Ahsan Safdar
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Contributions

All authors contributed to the study and their contributions are as follows: Concept: MUJ. Design: MUJ, MI. Supervision: MUJ, MI. Data Collection and/or Processing: MI, MUJ, SA, MSJ, MDK, NR, MAS. Analysis and/or Interpretation: MUJ, MI, SA, MSJ, MDK, NR, MAS. Literature Search: MI, MUJ, SA, MSJ, MDK, NR, MAS. Writing Manuscript: MUJ, MI, SA, MSJ, MDK, NR, MAS. Critical Review: MI, MUJ, SA, MSJ, MDK, NR, MAS. Proofreading: All authors have critically reviewed and approved the final draft and are responsible for the content and similarity index of the manuscript.

Corresponding authors

Correspondence to Muhammad Umair Javaid or Muhammad Ikrama.

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Conflict of interest

M. Umair Javaid, M. Ikrama, S. Abbas, M. Saad Javaid, M. Danial Khalid, N. Riaz and M. Ahsan Safdar declare that they have no conflict of interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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Umair Javaid, M., Ikrama, M., Abbas, S. et al. Exploring Roemheld syndrome: a comprehensive review with proposed diagnostic criteria. Herz (2024). https://doi.org/10.1007/s00059-024-05249-y

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