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Hiatal hernia squeezing the heart to flutter.

Arpan Patel1, Rushikesh Shah1, Sravanthi Nadavaram1

  • 1Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.

The American Journal of Emergency Medicine
|November 19, 2013
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Summary
This summary is machine-generated.

A large diaphragmatic hernia in an elderly woman caused atrial flutter by pressing on her heart. Surgical repair of the hernia resolved the cardiac arrhythmia, demonstrating a direct mechanical link.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Gastroenterology

Background:

  • Atrial flutter is a common cardiac arrhythmia.
  • Diaphragmatic hernias can cause various symptoms due to organ displacement.
  • Elderly patients may present with atypical symptoms like failure to thrive.

Observation:

  • An 80-year-old woman presented with failure to thrive and weakness.
  • She had a history of polio and presented with atrial flutter and elevated cardiac enzymes.
  • Imaging revealed a large diaphragmatic hernia, which was suspected to be the cause of her symptoms.

Findings:

  • The patient's atrial flutter persisted despite medical management.
  • Surgical repair of the diaphragmatic hernia was performed.
  • Postoperatively, the atrial flutter resolved, and the patient remained arrhythmia-free.

Implications:

  • This case highlights a rare mechanical cause of atrial flutter.
  • Diaphragmatic hernias should be considered in the differential diagnosis of unexplained arrhythmias in the elderly.
  • Surgical intervention can effectively treat arrhythmias caused by mechanical compression from hernias.