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Cholecystocardial syndrome is a complex symptom complex, manifested by various disorders in the heart, the development of which is facilitated by the presence of gallstone disease and other diseases of the biliary tract in the patient. For many years, clinicians around the world have been studying the relationship between acute and chronic diseases of the biliary tract and the cardiovascular system. Often these disorders are detected during an attack of biliary colic, in which painful sensations in the region of the heart often occur, and in some cases they are equivalent to an attack of biliary colic. In real clinical practice, cholecystocardial syndrome is an actual syndrome of interest to therapists, cardiologists, gastroenterologists and surgeons. The review presents data on its prevalence, causes and mechanism of development, clinical manifestations. Data on the incidence of cholecystocardial syndrome in real clinical practice vary significantly, which depends on the interpretation of the concept of cholecystocardial syndrome. With the introduction of ultrasound into the widespread practice, the diagnosis of cholelithiasis was significantly simplified, therefore, cholecystocardial syndrome in the classical version described by S.P. Botkin, has been found less and less recently. With a broader consideration of the concept of cholecystocardial syndrome as a complex of clinical symptoms indicating the possibility of changes on the part of the cardiovascular system, in patients with a diagnosed pathology of the biliary tract, its occurrence is quite high. The analysis of domestic data on the problem of cholecystocardial syndrome in real clinical practice, combined with data obtained as a result of a search of foreign literature on electronic biomedical databases (PubMed, MEDLINE, Scopus, Google Scholar) suggests the allocation of another mechanism of its development, associated with cholestasis, high levels of circulating bile acids and activation of bile acid receptors, and allows us to consider its cholecystocardial syndrome not only as a diagnostic syndrome during differential diagnosis, but also as a syndrome reflecting the comorbidity of the pathology of CVS and the biliary tract.

Acid-related diseases occupy a leading place in the structure of the incidence of the gastrointestinal tract. One of the important aspects of studying them now is to consider them in combination with coronary heart disease, hypertension, diabetes, asthma and other common diseases and conditions. Proton pump inhibitors are currently the basis for the treatment of acid-related diseases. Although all PPIs are very effective, the antisecretory effects of various drugs of this class may differ in different patients, especially in the presence of comorbidities and comorbidities. The pharmacokinetics and metabolism of rabeprazole are significantly different from those of other IPPs. The clearance of rabeprazole is largely non-enzymatic and depends little on the functioning of the cytochrome P450 (CYP) 2C19 system, which determines the predictability of the effect of rabeprazole and its safety for patients taking several drugs at the same time. A distinctive effect of rabeprazole is the activation of rabeprazole in a wide pH range, the presence of a gastroprotective effect and anti-helicobacter activity.

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