[A 77-year-old patient with suspected left atrial tumor]

A 77-year-old female presented with a suspected cardiac tumor and thrombosis of both legs diagnosed by phlebography with pulmonary embolism of both sides. In transthoracic echocardiography, transesophageal echocardiography, and CT no intracardial tumor was seen. There was a hiatal hernia which compressed the left atrium from outside. As echocardiographic criteria of hiatal hernia described by D'Cruz we found the left atrium filled with a solid mass and variation of compression of the left atrium depending on breathing. Because of the low incidence of cardiac tumors, differential diagnosis should be done if a cardiac tumor is suspected. A hiatal hernia should always be taken into consideration.