THE CLINICIAN is continually being reminded of the interrelationships between heart and gastrointestinal tract, in both their physiologic and pathologic activities. He sees the results of cardiac output changes in the patient who struggles against constipation via prolonged Valsalva effort; he encounters a type of postprandial myocardial infarction seemingly sparked by gluttony; he recognizes cardiac axis shifts during attacks of splenic flexure syndrome. Sometimes he observes dramatic interrelated catastrophes such as perforation of an esophageal or gastric fundal ulcer or cancer into the pericardial sac. Many other examples of the interrelationships can be contemplated. If one adds the problem of simply attempting to distinguish, at the bedside, between certain diseases of the two systems (angina pectoris vs a small direct hiatus hernia), he concludes readily that the relationships are not only complex, but can pose diagnostic dilemmas of a dangerous sort.
A surprisingly underpublicized heart-gut association is the Laubry-Soulle syndrome.
Palmer ED. Laubry-Soulle Syndrome: Forgotten Explanation for a Common Problem. JAMA. 1974;230(11):1575–1576. doi:10.1001/jama.1974.03240110065027
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