Echocardiographic manifestation of hiatus hernia simulating a left atrial mass: case report.
BACKGROUND
Despite the high prevalence of hiatus hernia, a relatively small number of echocardiographically manifested cases have been reported.


METHODS
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.


CONCLUSIONS
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.
Koskinas
Konstantinos C
KC
Cardiology Department, General Hospital of Edessa, 58200 Edessa, Greece. drkoskinas@yahoo.gr
Oikonomou
Kostas
K
Karapatsoudi
Eleni
E
Makridis
Pantelis
P
D000369:Aged, 80 and over; D001464:Barium; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006325:Heart Atria; D006338:Heart Neoplasms / Q000000981:diagnostic imaging*; D006551:Hernia, Hiatal / Q000000981:diagnostic imaging*; D006801:Humans; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
D001464:Barium
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