Related Experiment Video
Updated: Apr 27, 2026
10:52
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
4.9K
Hiatal hernia causing extrapericardial tamponade after coronary bypass surgery
Pavlos Papoulidis1, Jasmine Winter Beatty2, Uday Dandekar2
1University Hospital Coventry and Warwickshire, Coventry, UK ppapoul@hotmail.com.
Interactive Cardiovascular and Thoracic Surgery
|July 6, 2014
Summary
Cardiac tamponade, heart compression, can occur after coronary artery bypass graft surgery. A rare case highlights a giant hiatus hernia causing tamponade through external compression, emphasizing consideration of non-pericardial causes.
Area of Science:
- Cardiology
- Thoracic Surgery
- Gastroenterology
Background:
- Cardiac tamponade is a critical condition caused by pericardial fluid accumulation, leading to hemodynamic compromise.
- Off-pump coronary artery bypass graft (OPCAB) surgery is a standard procedure for coronary artery disease.
Observation:
- A 76-year-old female developed cardiac tamponade symptoms within 48 hours of OPCAB surgery.
- Initial investigations, including echocardiography and re-exploration, showed no internal clots or fluid.
- A giant hiatus hernia was identified as the cause of extrinsic compression on the heart.
Findings:
- The hiatus hernia exerted pressure on the pericardial sac, mimicking cardiac tamponade.
- Nasogastric tube insertion and gastric decompression rapidly improved the patient's clinical status.
Implications:
- This case underscores the importance of considering extrapericardial pathologies in postoperative cardiac tamponade.
- Hiatus hernias can present as a rare cause of cardiac tamponade, necessitating a broader differential diagnosis.
- Multidisciplinary evaluation involving cardiac surgeons and general surgeons is crucial for managing such complex cases.
Related Concept Videos
01:22Aneurysm IV: Nursing Management
620
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
620
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
457
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
457
01:25Hiatal Hernia
65
A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or...
65
01:26Aneurysm III: Interprofessional Care
478
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
478
01:28Esophageal Perforation-II: Clinical Manifestations and Management
1.0K
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
1.0K