In 2025, the following article was published in Annals Academy of Romanian Scientists Series on Biological Sciences, Volume 14 no 1, 2025:
Blendea AL, Guenne S, Ciobica A, Gotca I, Rață I, Gherasim A. The Cardiac Paradox of Losing Weight: A Review of Roemheld Gastrocardiac Syndrome. Academy of Romanian Scientists Annals – Series on Biological Sciences. 2025;14(1):203-214. DOI: 10.56082/annalsarscibio.2025.1.203.https://aos.ro/doi/biology-2025-1-203-the-cardiac-paradox-of-losing-weight-a-review-of-roemheld-gastrocardiac-syndrome
Article
The article provides an overview of the current scientific understanding of Roemheld Syndrome, also known as Gastrocardiac Syndrome. The authors describe Roemheld Syndrome as an under-recognized condition in which gastrointestinal disturbances may trigger cardiac symptoms such as palpitations, arrhythmias, chest discomfort, shortness of breath, dizziness, and even syncope (fainting).
According to the review, several mechanisms may explain the connection between the digestive system and the heart. These include excessive stimulation of the vagus nerve, gastric distension caused by bloating or large meals, gastroesophageal reflux disease (GERD), and mechanical compression of the heart by a large hiatal hernia.
The authors highlight research suggesting that large hiatal hernias may compress the left atrium and pulmonary veins, potentially contributing to symptoms such as palpitations, premature ventricular contractions (PVCs), and exercise intolerance. Other studies discussed in the review suggest that acid reflux and esophageal irritation may influence the autonomic nervous system, increasing susceptibility to certain arrhythmias.
The review also notes that Roemheld Syndrome is frequently mistaken for anxiety or panic disorder because many patients experience symptoms such as dizziness, sweating, anxiety, and a racing or irregular heartbeat. However, the authors emphasize that gastrointestinal triggers should be considered when symptoms repeatedly occur after meals, during bloating episodes, or in association with reflux.
Potential treatment strategies discussed include dietary modifications, eating smaller meals, treatment of acid reflux with proton pump inhibitors (PPIs), correction of hiatal hernias when appropriate, and addressing underlying gastrointestinal disorders. The authors stress that more research is needed, as most current knowledge is based on case reports and small studies rather than large clinical trials.
Key takeaway
This review does not provide definitive proof of the cause of Roemheld Syndrome. However, it offers a useful overview of the leading theories currently being investigated and highlights the growing scientific interest in the relationship between gastrointestinal disorders and heart-related symptoms.
Editor’s note
We welcome the publication of review articles such as this one because they help bring attention to an under-recognized condition. At the same time, many of the mechanisms discussed remain theoretical, and further research is needed to better understand the relationship between the digestive system and the heart.
Although the title (THE CARDIAC PARADOX OF LOSING WEIGHT: AREVIEW OF ROEMHELD GASTROCARDIAC SYNDROME) refers to weight loss, the article’s main focus is on how stomach distension, vagal reflexes, GERD, and hiatal hernias may contribute to cardiac symptoms in people with suspected Roemheld Syndrome. The discussion of weight loss primarily relates to the use of intragastric balloons, which can increase gastric volume and potentially trigger gastrocardiac symptoms in susceptible individuals.