Intractable hiccups: How can chest X-ray help?

Area of Science:

• Cardiology
• Pulmonology
• Internal Medicine

Background:

• Persistent hiccups can be a challenging clinical symptom.
• Refractory hiccups often prompt investigation into various underlying etiologies.
• Antacids are a common first-line treatment, but may be ineffective for serious causes.

Observation:

• A young male presented with intractable hiccups unresponsive to antacid therapy.
• A high index of suspicion led to diagnostic imaging.
• A chest X-ray was performed to investigate the persistent symptom.

Findings:

• The chest X-ray revealed a significant pericardial effusion.
• Drainage of the pericardial effusion led to the complete resolution of hiccups.
• This suggests a direct correlation between the effusion and the hiccup symptom.

Implications:

• Pericardial effusion should be considered in the differential diagnosis of refractory hiccups.
• Simple imaging modalities like chest X-ray are crucial for identifying serious underlying conditions.
• Early and accurate diagnosis through basic imaging can prevent prolonged patient suffering and guide effective treatment.