Kardiospazm

Kardiospazm (achalasia, megaesophagus, venospasm) - spasm cardial section of the esophagus, accompanied by partial obstruction and expansion of the overlying its departments. The disease is rare, occurs more often in people between the ages of 20 to 40 years. The origin of kardiospazm associated with birth defects, disorders of innervation of the esophagus. Of great importance in the pathogenesis of kardiospazm have dysfunctions of the Central and autonomic nervous system, mental trauma. At the beginning of the disease phenomena spasm are temporary, then become persistent; develop organic changes in cardiac esophagus. Overlying the esophagus dramatically expand, acquire saccular form. The diameter of the esophagus in the widest area can reach 16-18 see Wall advanced esophageal usually thickened. Stagnation and decay of food lead to the development of inflammation of the esophagus (esophagitis).
Leading clinical symptom of kardiospazm is dysphagia - swallowing impairment in connection with the difficulties of passage of food through the esophagus. The disease can begin sharply. During the meal (often after mental shocks) comes suddenly feeling delay in the esophagus solid food, sometimes the fluid. After a while the food passes into the stomach and unpleasant feeling disappears. In the future such attacks are repeated, delayed food becomes permanent. Kardiospazm may develop gradually. At first, a difficulty in passing food or liquid. Inadequate emptying of the esophagus leads to flooding, and in patients begins regurgitation stagnant food masses. In advanced cases the contents of the esophagus without strain of the patient's pouring outside, i.e. you receive regurgitation (see), endorsed the sense of pressure and dull pain in the sternum. With the development of the disease are mounting weight loss, weakness, impaired work capacity. There are reflex cardiovascular disorders. Due to aspiration of food masses can be complications of the respiratory tract (pneumonia, abscesses, atelectasis).
Diagnosis of kardiospazm not difficult. History and the characteristic clinical picture allow to suspect kardiospazm.

kardiospazm
Kardiospazm (1) and spasm lower third of the esophagus (2). Overlying the esophagus expanded.

The diagnosis to be confirmed x-ray examination of the esophagus (Fig). Differential diagnosis of kardiospazm should be conducted with a malignant tumour of the oesophagus and gastric cardia, diverticula and organic restrictions on the soil of burn of the esophagus or peptic ulcers of the esophagus. If you suspect kardiospazm the patient should be directed to the surgeon for examination and treatment.
Treatment in the early stages of the disease conservative: normalization General and food regimes (high-calorie foods with the exception of the hot and sour products), antispastic funds (papaverine, amyl nitrate), vitamin B1, ganglioblokatory car-sympathetic blockade by A. C. Vishnevskaya. In the absence of affect or simultaneously with the conservative treatment the rapid expansion the cardia using extenders different designs. In later stages of the disease apply surgical treatment.