Prof. Chen Bojun (Department of Emergency Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine)
Mr. Li recently had a strange disease: discomfort in the anterior chest area, rapid and slow heartbeat, and pain in the right upper abdomen. After treatment according to the heart disease method, the symptoms did not improve. The above symptoms no longer appear after the cholecystectomy for acute cholecystitis. This is the first time I’ve ever seen a woman with a heart condition, and I’ve never seen a woman with a heart condition. Chen Bojun, Cardiovascular Disease Specialist, Guangdong Provincial Hospital of Traditional Chinese Medicine
The so-called biliary heart syndrome refers to a clinical syndrome that causes cardiac symptoms, coronary artery blood supply deficiency, heartbeat rhythm disorders and ECG abnormalities when suffering from biliary diseases (cholecystitis, cholangitis, gallstones or tumors). Although they are fundamentally different, they are related, and are more common in biliary tract disorders, and are being paid more and more attention. Overseas scholars have analyzed 1000 patients with cholecystitis and found 329 cases with angina pectoris and myocardial ischemia, 149 of which were misdiagnosed as coronary heart disease and myocardial infarction. Domestic people have also reported cases of biliary heart syndrome misdiagnosed as angina pectoris of coronary heart disease.
Why does a patient with biliary tract disease have pain similar to angina pectoris? When the gallbladder and biliary tract are diseased, the gallbladder wall and biliary tract are stimulated by inflammation and stones, which travel upward through the vagus nerve reflex to the brain. This stimulation accumulates and then feeds back to the coronary arteries through nerve reflexes, causing contraction, narrowing, and reduced blood flow, resulting in coronary artery contraction and spasm, sudden reduction of coronary blood flow, myocardial ischemia and hypoxia and angina pectoris and severe arrhythmia, which can lead to sudden death. Since the cause of the disease is in the biliary tract, most of the cardiac symptoms will also improve after the lesions of the bile are cured.
In recent years, with the change of people’s dietary habits (mainly the increase of eating cholesterol foods), the incidence of biliary disease (especially cholelithiasis) has increased significantly, and the incidence of biliary heart syndrome has also increased dramatically. On the other hand, since middle-aged and elderly people are prone to coronary heart disease, biliary heart syndrome is also easily misdiagnosed as coronary heart disease, so the treatment is not only ineffective, but also delay the disease. Therefore, “angina pectoris” is not necessarily coronary heart disease, please do not forget to consider “biliary heart syndrome”.