Zusammenfassung
Meist wird der Ösophagus als Organ betrachtet das lediglich für differential diagnostische Überlegungen des Thoraxschmerzes eine Rolle spielt. So können eine gastroösophageale Refluxerkrankung oder Motilitätsstörungen Beschwerden auslösen, die klinisch nicht ohne weiteres von kardial bedingter Angina pectoris zu unterscheiden sind. Übersehen wird dabei daß vom Ösophagus ausgehende viszerale Afferenzen, die durch chemische (Säure) oder mechanische (Dehnung) Reize aktiviert werden, kardiale Funktionen beeinträchtigen. So besteht aufgrund der vorliegenden Daten heute kein Zweifel, daß die Infusion von Säure in die Speiseröhre bei einigen Patienten die Belastungstoleranz vermindert und EKG-Veränderungen (ST-Strecken-Senkungen, Rhythmusstörungen) induzieren kann. Diese Veränderungen sind wahrscheinlich Folge einer verminderten Koronardurchblutung.
Abstract
In the clinical setting the cardiologists’ interest is focussed on the esophagus as a potential source of thoracic pain as a differential diagnosis of angina pectoris. However, visceral afferences originating in the mucosal wall of the esophagus activated by acid exposure may also influence cardiac function. The available data convincingly demonstrate a reduction of the exertional angina threshold and changes of the EGG (ST segment depression and arrhythmia). These effects are most likely due to a reduced coronary blood flow.
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Holtmann, G., Schlömer, P. & Gerken, G. Bedeutung ösophagokardialer Reflexe für die Auslösung von Brustschmerzen. Herz 24, 154–157 (1999). https://doi.org/10.1007/BF03043854
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DOI: https://doi.org/10.1007/BF03043854