Arvind Ashwini, Niec Rachel, Hajifathalian Kaveh, Zarnegar Rasa, Wan David
Gastrointestinal Division, Massachusetts General Hospital & Harvard Medical School, Boston, MA.
Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY.
ACG Case Rep J. 2019 Dec 5;6(12):e00278. doi: 10.14309/crj.0000000000000278. eCollection 2019 Dec.
Hiatal hernia is a common pathology, particularly among the elderly or obese populations. Occasionally, markedly dilated hernias can impinge on surrounding structures, notably the heart or lung. In such cases, morbidity can be considerable. We present a case of an enlarging hiatal hernia that compressed the heart, leading to recurrent non-ST elevation myocardial infarction with cardiac tamponade. The patient was successfully managed with nasogastric decompression and surgical repair. We recommend that extrapericardial pathology be considered in tamponade patients with concurrent hiatal hernia and that surgery should be considered the definitive treatment modality.
食管裂孔疝是一种常见的病理状况，在老年人或肥胖人群中尤为常见。偶尔，明显扩张的疝会压迫周围结构，尤其是心脏或肺部。在这种情况下，发病率可能相当高。我们报告一例不断增大的食管裂孔疝压迫心脏的病例，导致复发性非ST段抬高型心肌梗死并伴有心脏压塞。该患者通过鼻胃管减压和手术修复成功治愈。我们建议，对于并发食管裂孔疝的心脏压塞患者，应考虑心包外病变，并且应将手术视为确定性的治疗方式。
