Koskinas Konstantinos C, Oikonomou Kostas, Karapatsoudi Eleni, Makridis Pantelis
Cardiology Department, General Hospital of Edessa, 58200 Edessa, Greece.
Cardiovasc Ultrasound. 2008 Sep 15;6:46. doi: 10.1186/1476-7120-6-46.
Despite the high prevalence of hiatus hernia, a relatively small number of echocardiographically manifested cases have been reported.
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.
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.
尽管食管裂孔疝的患病率很高，但经超声心动图表现的病例报告相对较少。
一名82岁女性因提示心脏病因的急性胸骨后疼痛就诊。体格检查、生化检查以及12导联心电图均正常。进行了二维经胸超声心动图检查，发现一个结构，被认为代表左心房肿块。随后的计算机断层扫描显示后纵隔有食管裂孔疝，压迫左心房后壁。上消化道钡餐检查进一步证实了大部分胃的胸腔内移位。
食管裂孔疝可表现为急性胸痛，其超声心动图表现可能类似于左心房占位性结构。医生应了解临床和超声检查结果，以便于与表现相似的心脏疾病进行鉴别诊断。
