Hiatal hernia mimicking ST elevation myocardial infarction
Karthiek Narala1, Sandeep Banga, Mark Hsu
1Department of Cardiology, University of Illinois College of Medicine, Peoria, Ill., USA.
Cardiology
|November 18, 2014
Summary
A large hiatal hernia caused ST segment elevation in a patient, mimicking a heart attack. This rare condition should be considered in diagnosing ST elevation causes.
Area of Science:
- Cardiology
- Gastroenterology
- Internal Medicine
Background:
- ST segment elevation on electrocardiogram (ECG) typically indicates acute myocardial infarction.
- Differential diagnosis for ST elevation is broad and includes various cardiac and non-cardiac conditions.
Observation:
- A 72-year-old male presented with abdominal pain, sweating, and rigors.
- ECG revealed ST segment elevation, prompting extensive cardiovascular work-up.
- Cardiovascular work-up was negative for occlusive coronary artery disease.
Findings:
- A large hiatal hernia was identified as the cause of the patient's symptoms.
- The hiatal hernia was directly linked to the observed ST segment elevation.
Implications:
- Hiatal hernia is an uncommon but critical differential diagnosis for ST segment elevation.
- This case highlights the importance of considering gastrointestinal causes in cardiac emergencies.
- Accurate diagnosis can prevent unnecessary cardiac interventions and guide appropriate management.
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