When the stomach rules the heart: dyspnea as a neglected complication of a large hiatal hernia.

摘要

Hiatal hernia is a common condition; its exact prevalence is uncertain because of disagreement about its definition, but some sources suggest that it is present in more than 50% of individuals older than the age of 50 years (1). Cardiologists are most commonly involved in the care of patients with hiatal hernia because of the diagnostic challenge posed by gastro-esophageal reflux in the differential diagnosis of chest pain. This entity also requires attention in relation to incidental findings on chest x-ray, difficulties in the performance of transesophageal echocardiography, and external compression of the left atrium causing an apparent left atrial mass (2,3).