Large Hiatal Hernia Compressing the Heart

Matar, Andrew; Mroue, Jad; Camporesi, Enrico M.; Mangar, Devanand; Albrink, Michael

doi:10.1016/j.amjcard.2015.10.064

Cited by 12 publications

(6 citation statements)

References 10 publications

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“…Hiatal hernia type I is the most frequent, constituting about 95% of all hiatal hernias, and most patients with this kind of hernia are asymptomatic but may have gastroesophageal refl ux. The clinical presentation of giant hiatal hernias like in the case of type IV could be very unspecifi c, with symptoms of gastroesophageal refl ux, thoracic pain, dyspnea, exercise intolerance, or in the course of an emergency like gastric volvulus, respiratory distress or cardiac shock by compression like in the present case [2].…”

Section: Discussionmentioning

confidence: 75%

“…The presentation with dyspnea and low cardiac output have been reported only in one previous case. The fi rst symptom can be due to refl ux mediated lung fi brosis or due to compression of cardiac structures like the left atrium and coronary sinus [2]. This kind of giant hiatal hernias use to be more frequent in elderly, manifested by dyspnea and cardiac failure due to compression, with hypoxemia, hypercapnia, and respiratory distress, those symptoms will improve with supplementary oxygen and allow us to suspect the cardiogenic origin [3].…”

Section: Discussionmentioning

confidence: 99%

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Incarcerated Giant Hiatal Hernia conditioning hearth shock: case report

Angel¹

2015

Arch Clin Gastroenterol

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Between the hiatal hernias, the type IV is the less frequent by the great defect, but this type had a high incidence of incarceration (5%), and a mortality rate up to 27%. Case:A female patient of 80 years-old was referred to our hospital by septic shock and abdominal pain. At physical exam she refers abdominal and thoracic pain, dyspnea and occasional threw up for the last 2 days, with a background of this symptoms the last 5 years, and gastroesophageal refl ux symptoms for 10 years. At admission, she referred epigastric and retrosternal pain, dyspnea, with an 02 of 75%, bowel sounds in left hemithorax, mean arterial pressure of 50mmHg with the use of norepinephrine. Laboratories do not reveal sepsis and CT scan reports a hiatal hernia of 9 cm with left hemithorax occupied by stomach, colon, and spleen. A cardiogenic shock by compression was suspected with this data and a laparotomy was scheduled. CT scan report was confi rmed and the mentioned organs were reduced to abdomen without problems, both diaphragmatic pillars were sutured and a Nissen fundoplication completed. After 6 hours' norepinephrine was suspended and 48 hours after the patient were discharged uneventfully. Conclusion:Giant hiatal hernia must be suspected in patients with chronic abdominal and thoracic pain with refl ux symptoms because the complications associated with this disease could have a mortality near 30% in case of strangulation and a scheduled surgery could be very safe in the correct moment.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Incarcerated Giant Hiatal Hernia conditioning hearth shock: case report

Angel¹

2015

Arch Clin Gastroenterol

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“…Hiatal hernia may be visualized in the transthoracic echocardiogram while it is encroaching on the posterior part of the left atrium and left atrioventricular junction [41]. Hiatal hernia is usually seen as an extracardiac posterior mass encroaching on the left atrial cavity, mimicking a left atrial mass on transthoracic echocardiography [25,[42][43][44][45][46][47][48][49][50][51][52][53][54]. However, this may not be obviously apparent since its visualization relates to the imaging plane and respiratory fluctuation [41].…”

Section: Tension Gastrothorax As Hiatal Hernia Complicationmentioning

confidence: 99%

Hiatal hernia as a rare cause of cardiac complications – case based review of the literature

Krawiec¹,

Szczasny²,

Kadej

et al. 2021

Ann Agric Environ Med.

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“…Comparison of the preoperative and postoperative work-up showed a great improvement in dyspnea (Modified Medical Research Council (mMRC) Dyspnea Scale 2 vs mMRC 4 before surgery), room air oxygen saturation (SpO 2 =97% vs 90%) and lung function (forced vital capacity=107% predicted vs 48% predicted). Huge hiatal hernia is particularly observed in elderly, and may cause dyspnoea1 and cardiac failure due to heart compression 2. Surgical repair is usually associated with a significant improvement of both symptoms and in pulmonary function tests 3…”

Section: Descriptionmentioning

confidence: 99%