scholarly journals A Large Intrathoracic Hiatal Hernia as a Cause of Complete Heart Block

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ali Abbood ◽  
Hareer Al Salihi ◽  
Jorge Parellada ◽  
Mario Madruga ◽  
S. J. Carlan
Keyword(s):  
Abdominal Pain ◽  
Gastroesophageal Reflux ◽  
Hiatal Hernia ◽  
Heart Block ◽  
Surgical Repair ◽  
Complete Heart Block ◽  
Normal Sinus Rhythm ◽  
Normal Sinus ◽  
Ventricular Response ◽  
The One

Hiatal hernia is a not uncommon anatomic disorder resulting in portions of the bowel occupying space in the thoracic cavity. There are a number of antecedent risk factors including obesity but not hiatal hernias resulting in symptoms. When symptoms do occur, they can include chest pain, nausea, abdominal pain, and gastroesophageal reflux. Cardiac arrhythmias have also been reported as associated conditions resulting from a hiatal hernia. To date, however, a complete heart block secondary to a hiatal hernia has not been reported. An 88-year-old female with a history of GERD (gastroesophageal reflux disease) was found to have a large hiatal hernia at endoscopy after she presented to the emergency department with nausea and abdominal pain. Prior to her scheduled surgical repair, she developed symptomatic third degree heart block which resolved with nasogastric tube deflation of the gastric contents. After surgical repair of the hiatal hernia, she developed episodes of atrial fibrillation with rapid ventricular response and was started on diltiazem. She eventually converted back to normal sinus rhythm and remained dysrhythmia free. In addition to other known arrhythmias associated with hiatal hernia, a complete heart block can also be seen. Acute management requires deflation of the chest occupying hernia. This appears to be the one of the first reported cases of complete heart block caused by hiatal hernia.

scholarly journals Transient Congenital Complete Heart Block: A Case Report

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 790
Author(s):  
Ying-Tzu Ju ◽  
Yu-Jen Wei ◽  
Ming-Ling Hsieh ◽  
Jieh-Neng Wang ◽  
Jing-Ming Wu
Keyword(s):  
Heart Block ◽  
Rare Case ◽  
Complete Heart Block ◽  
Normal Sinus Rhythm ◽  
Structural Heart Disease ◽  
Normal Heart ◽  
Complete Atrioventricular Block ◽  
Normal Sinus ◽  
Congenital Complete Heart Block ◽  
Complete Atrioventricular

Congenital complete heart block is defined as a complete atrioventricular block occurring prenatally, at birth, or within the first month of life. Congenital complete heart block has a high mortality rate, and in infants with normal heart morphology, it is often associated with maternal connective tissue disease. In these latter cases, neonatal congenital complete heart block is usually irreversible. We present a rare case of a female neonate who had bradycardia noted at a gestational age of 37 weeks. Her mother had no autoimmune disease history. She had no structural heart disease, and the serology surveys for autoantibodies including SSA/Ro and SSB/La were all negative. Without intervention or medication, her congenital complete heart block completely recovered to a normal sinus rhythm within 5 days. The cause of the transient congenital complete heart block was unknown in this case.

scholarly journals Successful Restoration of Complete Heart Block to Normal Sinus Rhythm by Primary Angioplasty of Dual Left Anterior Descending Artery

2017 ◽  
Vol 8 (2) ◽  
pp. 73-76
Author(s):  
Santosh Kumar Sinha ◽  
Vikas Mishra ◽  
Mukesh Jitendra Jha ◽  
Mahmadula Razi ◽  
Nasar Abdali ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Heart Block ◽  
Complete Heart Block ◽  
Normal Sinus Rhythm ◽  
Primary Angioplasty ◽  
Left Anterior Descending Artery ◽  
Normal Sinus

Symptomatic atrial bigeminy masquerading as congenital complete heart block

2021 ◽  
pp. 1-3
Author(s):  
Ernesto Mejia ◽  
Walter J. Hoyt ◽  
Christopher S. Snyder
Keyword(s):  
Heart Block ◽  
Complete Heart Block ◽  
Normal Sinus Rhythm ◽  
Pacemaker Implantation ◽  
Complete Atrioventricular Block ◽  
Holter Monitor ◽  
Normal Sinus ◽  
Congenital Complete Heart Block ◽  
Symptomatic Bradycardia ◽  
Complete Atrioventricular

Abstract Newborn male with symptomatic bradycardia initially diagnosed with complete atrioventricular block. Isoproterenol drip was initiated, and the patient was scheduled for pacemaker implantation. During the hospital course, repeat electrocardiogram and Holter monitor revealed evidence of near continuous blocked atrial bigeminy with occasional aberrantly conducted premature atrial contractions. Flecainide was started, resulting in normal sinus rhythm, and the pacemaker implantation was cancelled.

Complications of the Mustard Operation

1986 ◽  
Vol 8 (4) ◽  
pp. 106-126
Keyword(s):  
Heart Block ◽  
Normal Sinus Rhythm ◽  
Venous Blood ◽  
Resting Heart Rate ◽  
Normal Sinus ◽  
Mustard Operation ◽  
Mitral Orifice ◽  
The Mean ◽  
Degree Heart Block

Eight pediatric cardiac centers pooled clinical and ECG data from 372 patients who survived the Mustard operation (intraatrial baffle directing pulmonary venous blood to the tricuspid orifice and systemic venous blood to the mitral orifice) for at least 3 months. The follow-up period ranged from 0.4 to 15.9 years, and the mean age at operation was 2 years. The mean resting heart rate for patients who had the Mustard operation was consistently lower than age-matched controls. During the year of operation, 76% of patients had normal sinus rhythm; this percentage declined yearly to 57% by the end of the eighth postoperative year. Active arrhythmias increased after the tenth year. Second or third-degree heart block occurred in 33% of patients during the year of operation and changed very little thereafter. Of the total 372 patients, 39 received pacemakers, 52% during the year of surgery and 48% evenly distributed throughout the follow-up period.

Abstract 15549: Esophagopleural Fistula Associated Regional Pericarditis Mimicking Inferior Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Iain J Thompson ◽  
Jorge Fernandez ◽  
Hiroko Beck
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Normal Sinus Rhythm ◽  
Fluid Collection ◽  
Definitive Treatment ◽  
Normal Sinus ◽  
St Segment ◽  
Left Pleural Effusion ◽  
Patient Reported ◽  
Ventricular Response

Introduction: Regional pericarditis is a rare clinical entity that may mimic myocardial infarction (MI) and occurs most frequently after myocardial injury. We describe a unique case of regional pericarditis secondary to esophagopleural fistula (EPF) in a patient presenting to the catheterization lab for suspected ST-segment MI. Results: A 75-year-old man with non-small cell lung cancer presented with hypotension, weakness, dyspnea, and chest pain. The initial electrocardiogram (ECG: Figure 1) revealed normal sinus rhythm with inferior lead ST- segment elevations, a chest X-ray showed a left pleural effusion, and troponin I was <0.01 ng/ml. The patient underwent emergent coronary angiography showing no evidence of obstructive coronary disease. Subsequently, the patient reported palpitations and new onset dysphagia. An ECG revealed atrial fibrillation with rapid ventricular response. A barium esophagram (Figure 2) was performed to evaluate the dysphagia and revealed the presence of an EPF with fluid collection adjacent to the inferior heart border. The patient was treated for pericarditis with colchicine and definitive treatment with esophageal stenting was performed. Conclusions: We describe a case of regional pericarditis secondary to EPF masquerading as inferior MI. Given the prevalence and severity of MI, remaining cognizant of its mimickers such as regional pericarditis is important in clinical practice. This case report highlights the utility of maintaining a broad differential and performing a thorough history and physical both at initial presentation and when new information challenges the initial diagnosis.

scholarly journals Hiatal hernia and morbid obesity—‘Roux-en-Y gastric bypass’ the one step solution

2019 ◽  
Vol 2019 (6) ◽  
Author(s):  
Mohsin Khan ◽  
Aloy J Mukherjee
Keyword(s):  
Morbid Obesity ◽  
Gastric Bypass ◽  
Gastroesophageal Reflux ◽  
Hiatal Hernia ◽  
Good Alternative ◽  
Morbidly Obese ◽  
Co Morbidity ◽  
Giant Hiatal Hernia ◽  
One Step ◽  
The One

Abstract Obesity and hiatal hernia go hand in hand as siblings. Morbidly obese patients commonly have gastroesophageal reflux (GERD) and associated hiatal hernias (HH). The gold standard for all symptomatic reflux patients is still surgical correction of the paraesophageal hernia, hiatal closure and fundoplication. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective surgical treatment for morbid obesity and is known to effectively control symptoms of gastroesophageal reflux (GERD). It appears to be safe and feasible and becoming more common. Moreover, LRYGB plus Hiatus hernia repair (HHR) appears to be a good alternative for HH patients suffering from morbid obesity as well than antireflux surgery alone because of the additional benefit of significant weight loss and improvement of obesity related co-morbidity. One patient suffering from giant hiatal hernia and morbid obesity where a combined LRYGB and HHR without mesh was performed is presented in this paper.

scholarly journals Syncope Caused by Huge Hiatal Hernia

2011 ◽  
Vol 2011 ◽  
pp. 1-2 ◽  
Author(s):  
Gabriel Vanerio
Keyword(s):  
Blood Pressure ◽  
Hiatal Hernia ◽  
Normal Sinus Rhythm ◽  
White Female ◽  
Loss Of Consciousness ◽  
X Ray ◽  
Normal Sinus ◽  
Carbonated Soft Drinks ◽  
Chest X Ray ◽  
Careful History

A 84-year-old white female had a brief loss of consciousness while playing bridge. A few minutes before the episode she had eaten pizza and significant amount of carbonated soft drinks. After recovery, her friends noticed that she was alert, but pale and sweating. Upon arrival at the emergency room, sitting blood pressure was 160/60 mmHg with a normal sinus rhythm. A chest X-Ray was performed, which was essential to make the diagnosis. The X-Ray showed a large retrocardiac opacity with air and liquid level compatible with a giant hiatus hernia. After a copious snack the hiatal hernia compressed the left atrium, decreasing the left cardiac output, elucidating the mechanism of the syncopal episode. In patients presenting with swallow syncope (particularly after a copious meal, validating the importance of a careful history), a chest X-Ray should be always be performed.

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