Echocardiographic manifestation of hiatus hernia simulating a left atrial mass: Case report

Despite the high prevalence of hiatus hernia, a relatively small number of echocardiographically manifested cases have been reported. Case Presentation An 82-year old woman presented with acute retrosternal pain indicative of cardiac etiology.

Physical examination and biochemical tests, as well as 12-lead electrocardiogram, were normal. A two-dimensional transthoracic echocardiogram was performed and revealed a structure that was considered to represent a left atrial mass.

A subsequent computed tomography scan visualized a hiatus hernia in the posterior mediastinum, impinging on the posterior left atrial wall. The intrathoracic displacement of a large part of the stomach was further confirmed by an upper gastrointestinal barium examination.

Conclusion: Hiatus hernia can present as acute chest pain, while its echocardiographic manifestation may resemble a left atrial space-occupying structure. Physicians should be aware of the clinical and sonographic findings to facilitate the differential diagnosis from similarly presenting cardiac entities.

Author: Konstantinos C Koskinas, Kostas Oikonomou, Eleni Karapatsoudi and Pantelis Makridis
Credits/Source: Cardiovascular Ultrasound 2008, 6:46

Published on: 2008-09-15

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