Key result
Large hiatal hernia presents as ST-segment elevation via LV compression despite normal coronary arteries.
Why the study?
A large hiatal hernia can induce cardiac symptoms resulting from cardiac compression, but its association with left ventricular obstruction causing chest pain is not well recognized.
Case Report (n=1)
A large hiatal hernia can cause cardiac compression leading to left ventricular obstruction and symptoms mimicking acute myocardial infarction.
Alerts to extrinsic LV compression as STEMI mimic with normal coronaries; leaves open etiology and management.
A 76-year-old man was admitted to our emergency department owing to chest pain, which started immediately after lunch. Although electrocardiogram revealed ST-segment elevation with hyperacute T-wave changes in the anterior lead tracings, emergency coronary angiography revealed normal coronary arteries. Echocardiography revealed left ventricular (LV) compression with left ventricular obstruction (LVO) caused by an echogenic mass. Computed tomography clearly revealed compression of both left atrial (LA) and LV by a large hiatal hernia. A large hiatal hernia can induce cardiac symptoms resulting from cardiac compression. This case highlights a possible association between chest pain and LVO caused by a hiatal hernia.
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Harada et al. (2017) conducted a case report in Left ventricular obstruction caused by a large hiatal hernia (n=1). Large hiatal hernia was evaluated on Left ventricular obstruction and cardiac compression. A large hiatal hernia caused left ventricular obstruction and cardiac compression, presenting as chest pain with ST-segment elevation despite normal coronary arteries.
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