Extrinsic collapse of the left atrium by a large hiatal hernia

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87 years old male with a history of hypertension and ischemic cardiopathy. He arrives to the Emergency department with sudden intense epigastralgia, precordial oppression with irradiation to the interscapular area, profuse sweating, associated sensation of dyspnoea and palpitations. The patient is m...

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Autores principales: González-Munera, Adriana, Santos-Martínez, Ana, Vanegas-Rodríguez, Jesús
Formato: Artículo revista
Lenguaje:Español
Inglés
Publicado: Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2018
Materias:
hernia hiatal
estómago
atrios cardíacos
hernia
hiatal
stomach
heart atria
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/17082
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Revistas de la UNC de Universidad Nacional de Córdoba
id I10-R10-article-17082
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spelling I10-R10-article-170822019-05-20T10:54:31Z Extrinsic collapse of the left atrium by a large hiatal hernia Colapso extrínseco de la aurícula izquierda por hernia hiatal gigante González-Munera, Adriana Santos-Martínez, Ana Vanegas-Rodríguez, Jesús hernia hiatal estómago atrios cardíacos hernia hiatal stomach heart atria 87 years old male with a history of hypertension and ischemic cardiopathy. He arrives to the Emergency department with sudden intense epigastralgia, precordial oppression with irradiation to the interscapular area, profuse sweating, associated sensation of dyspnoea and palpitations. The patient is monitored and a venous peripheral access is placed. It is remarkable the variable blood pressure measures in the semi-stationary position, both in the upper left limb as in the contralateral limb. In the upper left limb we registrered 220/80 mmHg, followed by 100/50 mmHg and finally 170/95 mmHg. In the upper right limb, blood pressure was 180/40 mmHg and afterwards 120/70 mmHg. Proximal and distal pulses are present and no pulsatile epigastric mass can be found. Given the suspicion of an aortic syndrome, a CT scan with intravenous contrast is performed which shows a large hiatal hernia compromising partially the left atrium and inferior lobar veins (Fig 1-4). The patient is transferred to the observation area, where a nasogastric tube is placed, presenting partial symptomatic improvement, with persistent nausea and vomiting, as well as a tendency to hypertension. After being evaluated by general surgery, it was decided to make an hernia content reduction to the abdominal cavity and posterior fundoplication with residual fundus (Toupet type). There were no perioperative complications. After several days of hospitalization, the patient was referred to his home with no further incidences. Varón de 87 años, con antecedentes de hipertensión arterial y cardiopatía isquémica. Ingresa en box vital de urgencias por epigastralgia intensa, súbita, asociada a cortejo vegetativo, que se irradia hacia zona interescapular. Llaman la atención cifras tensionales muy variables (80-220/50-100 mmHg) con cambios posturales. Los pulsos proximales y distales están presentes y no se palpa masa pulsátil en abdomen. Se realiza una tomografía computarizada con contraste que evidencia una hernia de hiato esofágico gigante por deslizamiento que condiciona colapso parcial de la aurícula izquierda y venas lobares inferiores (Fig 1-4). Tras fracaso del manejo conservador con SNG, requirió reducción quirúrgica y funduplicatura posterior.  Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2018-02-27 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf application/pdf image/jpeg image/jpeg image/jpeg image/jpeg https://revistas.unc.edu.ar/index.php/med/article/view/17082 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 75 No. 1 (2018); 64-65 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 75 Núm. 1 (2018); 64-65 Revista da Faculdade de Ciências Médicas de Córdoba; v. 75 n. 1 (2018); 64-65 1853-0605 0014-6722 10.31053/1853.0605.v75.n1 spa eng https://revistas.unc.edu.ar/index.php/med/article/view/17082/20077 https://revistas.unc.edu.ar/index.php/med/article/view/17082/21310 https://revistas.unc.edu.ar/index.php/med/article/view/17082/26516 https://revistas.unc.edu.ar/index.php/med/article/view/17082/26517 https://revistas.unc.edu.ar/index.php/med/article/view/17082/26518 https://revistas.unc.edu.ar/index.php/med/article/view/17082/26519 Derechos de autor 2018 Universidad Nacional de Córdoba
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-10
container_title_str Revistas de la UNC
language Español
Inglés
format Artículo revista
topic hernia hiatal
estómago
atrios cardíacos
hernia
hiatal
stomach
heart atria
spellingShingle hernia hiatal
estómago
atrios cardíacos
hernia
hiatal
stomach
heart atria
González-Munera, Adriana
Santos-Martínez, Ana
Vanegas-Rodríguez, Jesús
Extrinsic collapse of the left atrium by a large hiatal hernia
topic_facet hernia hiatal
estómago
atrios cardíacos
hernia
hiatal
stomach
heart atria
author González-Munera, Adriana
Santos-Martínez, Ana
Vanegas-Rodríguez, Jesús
author_facet González-Munera, Adriana
Santos-Martínez, Ana
Vanegas-Rodríguez, Jesús
author_sort González-Munera, Adriana
title Extrinsic collapse of the left atrium by a large hiatal hernia
title_short Extrinsic collapse of the left atrium by a large hiatal hernia
title_full Extrinsic collapse of the left atrium by a large hiatal hernia
title_fullStr Extrinsic collapse of the left atrium by a large hiatal hernia
title_full_unstemmed Extrinsic collapse of the left atrium by a large hiatal hernia
title_sort extrinsic collapse of the left atrium by a large hiatal hernia
description 87 years old male with a history of hypertension and ischemic cardiopathy. He arrives to the Emergency department with sudden intense epigastralgia, precordial oppression with irradiation to the interscapular area, profuse sweating, associated sensation of dyspnoea and palpitations. The patient is monitored and a venous peripheral access is placed. It is remarkable the variable blood pressure measures in the semi-stationary position, both in the upper left limb as in the contralateral limb. In the upper left limb we registrered 220/80 mmHg, followed by 100/50 mmHg and finally 170/95 mmHg. In the upper right limb, blood pressure was 180/40 mmHg and afterwards 120/70 mmHg. Proximal and distal pulses are present and no pulsatile epigastric mass can be found. Given the suspicion of an aortic syndrome, a CT scan with intravenous contrast is performed which shows a large hiatal hernia compromising partially the left atrium and inferior lobar veins (Fig 1-4). The patient is transferred to the observation area, where a nasogastric tube is placed, presenting partial symptomatic improvement, with persistent nausea and vomiting, as well as a tendency to hypertension. After being evaluated by general surgery, it was decided to make an hernia content reduction to the abdominal cavity and posterior fundoplication with residual fundus (Toupet type). There were no perioperative complications. After several days of hospitalization, the patient was referred to his home with no further incidences.
publisher Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2018
url https://revistas.unc.edu.ar/index.php/med/article/view/17082
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AT santosmartinezana extrinsiccollapseoftheleftatriumbyalargehiatalhernia
AT vanegasrodriguezjesus extrinsiccollapseoftheleftatriumbyalargehiatalhernia
AT gonzalezmuneraadriana colapsoextrinsecodelaauriculaizquierdaporherniahiatalgigante
AT santosmartinezana colapsoextrinsecodelaauriculaizquierdaporherniahiatalgigante
AT vanegasrodriguezjesus colapsoextrinsecodelaauriculaizquierdaporherniahiatalgigante
first_indexed 2022-08-20T01:24:53Z
last_indexed 2022-08-20T01:24:53Z
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