Dynamic electrocardiographic changes due to cardiac compression by a giant hiatal hernia.
A 79-year-old woman was admitted due to chest pain with T wave inversion and anasarca. Echocardiography demonstrated a mass compressing the heart and computed tomography revealed a giant hiatal hernia within the intrathoracic stomach located just behind the heart. After drainage of the gastric contents, the T wave inversion disappeared, but subsequent ST elevation in leads V1-V6 was noted. After surgical correction of the hiatal hernia, the ST segment elevation returned to a nearly normal level. The changes in the compressed heart induced by hiatal hernia may cause pericarditis resulting in electrocardiographic changes.
Hokamaki
Jun
J
Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556.
Kawano
Hiroaki
H
Miyamoto
Shinzo
S
Sugiyama
Seigo
S
Fukushima
Ryuichiro
R
Sakamoto
Tomohiro
T
Yoshimura
Michihiro
M
Ogawa
Hisao
H
D000368:Aged; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology*; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006551:Hernia, Hiatal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D014057:Tomography, X-Ray Computed