Failure to obtain a transoesophageal echocardiographic window because of a rolling hiatal hernia.

A man with a murmur and missing heart

“…7 8 Only one previously published case was identified from a PubMed search. 8 After the inconclusive transoesophageal echocardiogram, our patient underwent cardiac magnetic resonance imaging, which showed a mean aortic valve gradient of 30 mm Hg, left ventricular ejection fraction of 64%, stroke volume of 62 mL, and stroke volume index of 17 mL/beat/m 2 . These all indicated mild to moderate aortic stenosis and he was therefore managed medically with regular assessment of cardiovascular risk factors for ischaemic heart disease, mainly by his GP.…”

Transesophageal Two‐Dimensional Echocardiographic Identification of Hiatal Hernia

“…A few cases of hiatal hernia presenting as an extracardiac mass on two‐dimensional transthoracic echocardiography, 2–5 and less commonly on two‐dimensional transesophageal echocardiography, 3, 5, 6 have been reported. These have been described as posterior echogenic or echolucent masses without description of any inner lining or the presence of microbubbles.…”