Incidental Diagnosis of Hiatal Hernia Simulating a Left Atrial Mass: A Case Report

Hiatal Hernia-one of the most frequently encountered gastrointestinal conditions that rarely mimics cardiac pathology on imaging. We present a case of an elderly female where a hiatal hernia appeared as a left atrial mass on transthoracic echocardiography, raising concern for a benign cardiac tumor, while chest radiography revealed a retrocardiac air-fluid level suggestive of a hiatal hernia. Definitive diagnosis was established with contrast-enhanced computed tomography of the chest. Our goal is to raise awareness of hiatal hernia as an important differential diagnosis when evaluating an apparent cardiac mass on imaging and to emphasize the value of different imaging modalities, especially chest radiography, in preventing misdiagnosis of this rare presentation in resource-limited health care settings of developing countries like Bangladesh.