CARDIOSCAM

CARDIOSPASM (syn: achalasia cardia) - absence of reflex relaxation of the lower esophageal sphincter during swallowing, accompanied by partial obstruction of food and expansion of the overlying esophagus. Occurs more often in the age of 20 to 40 years. In the etiology and pathogenesis of cardiopathism, the disturbances in the functions of the central and autonomic nervous system, the mental trauma, and the role of a viral infection can play a role.

At the beginning of the disease, the spasm of the cardial section of the esophagus arises periodically, but then it becomes more frequent and becomes permanent. The higher parts of the esophagus gradually expand, acquiring a saccular form. Against the background of stagnation in their food, inflammation of the esophagus (esophagitis) develops.

The leading clinical symptom is dysphagia - a violation of swallowing due to the difficulty of passing food through the esophagus. During meals, suddenly there is a sense of delay in the esophagus of solid food, sometimes liquid. After a while, the food runs into the stomach, and an unpleasant sensation disappears. In the future, such attacks are repeated, food delay becomes constant. Insufficient emptying of the esophagus leads to its overflow, and in patients there is regurgitation of stagnant food masses. In neglected cases, the contents of the esophagus without tension on the part of the patient pour outward; There is regurgitation ; Attached feeling of pressure and dull pain behind the sternum. The onset of asthma attacks may indicate that there is compression of the mediastinal organs by an enlarged esophagus. There is a general weakness, weight loss, cardiovascular disorders. Due to aspiration of dietary masses, pneumonia is possible; Abscesses and atelectasis of the lungs.

The diagnosis is clarified by X-ray examination of the esophagus, which makes it possible to identify the difficulty of passing the radiopaque substance into the stomach, narrowing of the cardial segment and expansion of the overlying esophagus, absence of the gastric gas bubble. If a patient is suspected of having cardiopathy, the patient should be referred to a hospital for examination and treatment.

Treatment in the initial stages of the disease is conservative. It includes normalization of the general and food regimes (frequent, fractional nutrition, mechanically sparing high-calorie food with the exception of acute and acidic foods), the appointment of anticholinergic drugs (atropine) and antispasmodics (papaverine, no-shpa), nitrates, calcium antagonists, sedatives. In the absence of the effect of conservative treatment, or simultaneously with it, cardiodilation is performed: forced expansion of the cardial section of the esophagus with the help of an inflated balloon. In the late stages of the disease with ineffectiveness of cardiodilation, surgery is performed - esophagocardiomyotomy.