title: Large mass impinging on the left atrium: diagnostic value of a new cocktail.
abstract: The differential for a large mass impinging on the left atrium should include a hiatal hernia. When a hiatal hernia is suspected, the patient can be asked to ingest a carbonated beverage. Oftentimes, the beverage and bubbles can help delineate the herniation on echocardiography. This technique can make the diagnosis, but it is not always successful. WE report a case of a patient with a large hiatal hernia which was clearly demonstrated by having the patient swallow a carbonated beverage mixed with 1.5 ml of activated Definity contrast media. This novel cocktail has not been described in the literature to date.
authors.affiliation: Section of Cardiology, Department of Internal Medicine, University of Chicago Hospitals, Chicago, Illinois 60637, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Smelley
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lang
mesh_terms: D000284:Administration, Oral; D000368:Aged; D002303:Cardiac Output, Low / Q000000981:diagnostic imaging* / Q000209:etiology*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006551:Hernia, Hiatal / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren