1Division of Cardiology, Okinawa Chubu Hospital, 281 Miyazato, Uruma, Okinawa, Japan
American Journal of Medical Case Reports.
2017,
Vol. 5 No. 4, 89-93
DOI: 10.12691/ajmcr-5-4-4
Copyright © 2017 Science and Education PublishingCite this paper: Kazuhito Hirata, Yuji Shimabukuro, Takanori Takahashi, Minoru Wake. Syncope Due to Intracavitary Left Ventricular Obstruction Secondary to Giant Esophageal Hiatus Hernia.
American Journal of Medical Case Reports. 2017; 5(4):89-93. doi: 10.12691/ajmcr-5-4-4.
Correspondence to: Kazuhito Hirata, Division of Cardiology, Okinawa Chubu Hospital, 281 Miyazato, Uruma, Okinawa, Japan. Email:
kheart911@yahoo.co.jpAbstract
Esophageal hiatus hernia has been known to cause symptoms of congestive heart failure or syncope after meal due to compression of the heart, mainly the left atrium. However, compression of the left ventricle resulting in syncope has never been reported. Seventy-one year old woman developed syncope after taking a lunch. A chest roentgenogram showed possible mass lesion behind the heart. An echocardiogram revealed a mass lesion posterior to the left ventricle, resulting in “banana-shaped” deformity. A CT scan revealed a giant esophageal hiatus hernia which compressed the left ventricle. Cardiac catheterization revealed marked pressure gradient in the left ventricle suggestive of intracavitary obstruction after isoproterenol infusion. Left ventricular compression due to enlarged giant hiatus hernia after meal resulted in intracavitary obstruction of the left ventricle, causing syncopal episode in this particular patient. Dehydration and diastolic dysfunction may also have contributed.
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