title: Syncope upon swallowing caused by an esophageal hiatal hernia compressing the left atrium: a case report.
abstract: We describe a patient with syncope associated with swallowing. This syncope was caused by transient compression of the left atrium (LA) by an esophageal hiatal hernia. Two-dimensional echocardiography demonstrated a hyperechoic mass compressing the LA from the posterior. With air insufflation of the esophagus, compression of the LA by this hernia sac was seen to increase. Pulsed and color Doppler echocardiography revealed greatly decreased velocity of blood flowing into the LA and left ventricle (LV). Thus, marked compression of the LA by an esophageal hiatal hernia can cause syncope by impeding blood flow from the LA to the LV. Echocardiography proved highly useful in diagnosis.
authors.affiliation: Cardiovascular Section, National Higashi Tokushima Hospital, 1-1 Ohmukai-kita, Ohtera, Itano, Tokushima 779-0193, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Oishi
authors.forename: Takeo
authors.initials: T
authors.lastname: Ishimoto
authors.forename: Norio
authors.initials: N
authors.lastname: Nagase
authors.forename: Kenichi
authors.initials: K
authors.lastname: Mori
authors.forename: Sayuri
authors.initials: S
authors.lastname: Fujimoto
authors.forename: Shigehito
authors.initials: S
authors.lastname: Hayashi
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Ochi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Tomotsugu
authors.initials: T
authors.lastname: Tabata
authors.forename: Takashi
authors.initials: T
authors.lastname: Oki
mesh_terms: D000368:Aged; D003679:Deglutition; D018618:Echocardiography, Doppler, Color; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006551:Hernia, Hiatal / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D013575:Syncope / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed