Roemheld syndrome is characterized strictly by abdominal maladies triggering reflexes in the heart. There are a number of pathways through which cardiac reflexes can occur: hormones, mechanical, neurological and immunological.
Mechanical

Mechanically induced RS is characterized by pressure in the epigastric and left hypochondriac region. Often the pressure is in the fundus of the stomach, esophagus or distention of the bowel. It is believed this leads to elevation of the diaphragm, and secondary displacement of the heart. This reduces the hearts ability to fill and increases the contractility of the heart to maintain homeostasis.
Neurological

The mechanical changes in the gut can compress the vagus nerve at any number of locations along the vagus, slowing the heart. As the heart slows, autonomic reflexes are triggered to increase blood pressure and heart rate.

This is complemented by gastro-coronary reflexes whereby the coronary arteries constrict with "functional cardiovascular symptoms" similar to chest-pain on the left side and radiation to the left shoulder, dyspnea, sweating, up to angina pectoris -like attacks with extrasystoles, drop of blood pressure, and tachycardia (high heart beat) or sinus bradycardia (heart beat below 60). Typically, there are no changes / abnormalities related in the EKG detected. This can actually trigger a heart attack for persons with cardiac structural abnormalities i.e. coronary bridge, missing coronary, and atherosclerosis.


This sounds a lot like our vagus like palps or from the GI.
Roemheld syndrome it is called. Roemheld isnt 100% benign.

So my question is, what is the difference and how do you know what kind of problems you have?

mine is accompanied with many gass, active bowels, burping a lot , pain on the bit right side of the sternum often. pain below the sternum. bodily positions. cant have exercising too much or my heart rate explodes. I have hiatus hernia. Roemheld doesnt sound as anxiety , only you can experience anxiety due to the symptoms. Thats more what sounds right imo. and how it all started in my case. In the beginning I wasnt anxious. I just had the symptoms. When it became worse the anxiety kicked in with it

It is said here its not 100% benign.
or do i misunderstand ?
I know and understand i have no acute life threatening problem, otherwise I would have died already the past 4.5 years.
What I do want to know. How do I know I have Roemheld or only anxiety , or GI vagus, or.. and why will this always be benign?

The question is wether it can be said to be a "disease". Even Wikipedia states that: "Determining the cause of Roemheld syndrome is still not an exact science. If you have an ultrasound or sleep study, ensure that you know how to reproduce the symptoms, as it is difficult to detect any abnormalities when symptoms have subsided."

As I see it, it is a list of symtomps which sometimes, and sometimes not are causal connected. But interesting reading.