Abstract
The gastrocardiac syndrome was coined originally at the beginning of the 19th century to describe an alleged gastric-cardiopathy with reflux heartburn mimicking cardiac chest pain. Today, a wider perspective of gastrocardiac syndrome has emerged. First, the cardiovascular risk factor chronic systemic inflammation may reflect gastroenterological inflammatory conditions, such as inflammatory bowel disease and gastrointestinal infections, in particular, chronic Helicobacter pylori infection. Furthermore, since contemporary treatment of cardiovascular disease commonly includes potent antithrombotic medications, the cardiovascular benefit in terms of a decrease in the incidence of recurrent ischemic events and death needs to be carefully balanced with an increased risk of gastrointestinal bleeding. Several strategies to target chronic gastrointestinal inflammation and to diagnose and treat Helicobacter pylori to reduce the risk of cardiovascular events and gastrointestinal bleeding are available but residual controversy remains and large-scale gastro-cardiology trials are needed to determine the optimal treatment approaches. In perspective, the centennial gastrocardiac syndrome is more relevant than ever in a contemporary gastroenterology and cardiology setting. A collaborative subspecialty, namely Gastro-cardiology, would introduce novel unique means to study, diagnose and treat gastrocardiac conditions with the aim to reduce the risk of cardiovascular and bleeding events to improve the prognosis for gastro-cardiology patients.
Highlights
The gastrocardiac syndrome was coined by Ludwig von Roemheld in 1913 to describe an alleged gastric-cardiopathy [1]
In addition to inflammatory bowel disease, the centenarian gastrocardiac syndrome can today be extended to chronic inflammation through Helicobacter pylori (H. pylori) infection as an additional ventriculo-duodenal causal factor for atherosclerosis progression and cardiovascular events [6]
A common gastro-cardiology fight to dampen inflammation can be further encouraged by H. pylori being one of the most common chronic infections in the world with an estimated global prevalence of 50% [8] and the potential that lowering inflammation reduces the burden of the most common mortality cause from cardiovascular disease
Summary
The gastrocardiac syndrome was coined by Ludwig von Roemheld in 1913 to describe an alleged gastric-cardiopathy [1]. Contemporary cardiology did not adopt this diagnosis and reduced the gastrocardiac syndrome to define reflux heartburn mimicking cardiac chest pain. Modern cardiology is rapidly developing a close relation to other medical specialties. Cardio-oncology has been formalized, and for example, cardio-rheumatology and cardionephrology emerge as subspecialties. The frequent intersections of the roads of gastroenterologists and cardiologists in the centennium following the coining of Roemheld of gastrocardiac provide the perspective to debouch in gastro-cardiology today
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