Cholecystocardial syndrome in real clinical practice

Abstract

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.

Repeatedly Malignant ST-Segment Elevation

“…The ECG indicated ST-segment elevation in inferior leads and third-degree AV block. Considering that coronary artery vasospasm might result from cholecystocardial syndrome (CCS) caused by malignant duodenal tumor, isosorbide mononitrate and nifedipine were administered to prevent it. A combination of gastrojejunostomy and pancreaticoduodenectomy was performed on the 46th day of admission after implantation of a temporary pacemaker.…”

Comorbidity of gastroenterological and cardiovascular pathology as a problem of clinical practice

“…«Холецистокардиальный синдром» (ХКС) (синдром Боткина) исторически присутствует в отечественной медицине, подчеркивая сложность дифференциальной диагностики нарушений работы сердца, связанных с желчнокаменной болезнью, и собственно ССЗ [60][61][62]. Механизмы реализации ХКС включают рефлекторное влияние на миокард со стороны желчевыводящих путей, метаболические нарушения, связанные с вторичным нарушением функции печени и поджелудочной железы, инфекционно-токсическим воздействием на миокард [60][61][62].…”