Gastrocardiac syndrome: A forgotten entity.

Area of Science:

• Cardiology
• Gastroenterology
• Internal Medicine

Background:

• Symptomatic bradycardia is a clinical finding requiring investigation into its underlying cause.
• Gastric distension is an uncommon but reported cause of bradycardia, mediated by complex gastrointestinal-cardiac reflexes.
• Understanding this association is crucial for accurate diagnosis and management of unexplained bradycardia.

Observation:

• A 75-year-old female presented with recurrent dizziness.
• These episodes were temporally associated with episodes of significant gastric distension.
• Cardiac evaluation revealed severe sinus bradycardia correlating with gastric distension, with no underlying cardiac pathology.

Findings:

• The patient's severe sinus bradycardia resolved upon alleviation of gastric distension.
• This suggests a direct link between gastric distension and symptomatic bradycardia in this individual.
• No structural or functional cardiac abnormalities were identified to explain the bradycardia.

Implications:

• Gastric distension should be considered in the differential diagnosis of unexplained symptomatic bradycardia, especially in patients with recurrent episodes.
• This case underscores the importance of a thorough patient history and physical examination to identify potential gastrointestinal triggers for cardiac events.
• While conservative management of gastric distension may be attempted, recurrent symptomatic bradycardia may necessitate interventions like permanent pacemaker implantation, as in this case.