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Pseudo-hyperacute T Waves in a Giant Hiatal Hernia.
Hiroki Ono1, Teruyoshi Uetani1, Shinji Inaba2
1Department of Cardiology, Ehime Prefectural Imabari Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|February 8, 2023
Summary
A large hiatal hernia can cause chest pain and ECG changes mimicking a heart attack. Treating the hernia resolved these symptoms, highlighting a crucial differential diagnosis.
Area of Science:
- Cardiology
- Gastroenterology
- Medical Diagnostics
Background:
- Giant hiatal hernias can cause significant intrathoracic mass effect.
- Chest pain is a common symptom requiring urgent cardiac evaluation.
- Electrocardiogram (ECG) abnormalities can indicate acute myocardial infarction.
Observation:
- An 89-year-old female presented with persistent chest pain.
- Her ECG revealed hyperacute T waves, suggestive of ST-elevation myocardial infarction.
- The patient had a giant hiatal hernia.
Findings:
- Endoscopic drainage of the giant hiatal hernia was performed.
- Following the procedure, the patient's chest pain resolved completely.
- Resolution of chest pain correlated with the normalization of ECG abnormalities.
Implications:
- Giant hiatal hernias can compress cardiac structures, leading to ECG changes.
- This case underscores the importance of considering non-cardiac causes of chest pain and ECG abnormalities.
- Accurate diagnosis and management of hiatal hernias can prevent unnecessary cardiac interventions.
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