scholarly journals Syncope Caused by Huge Hiatal Hernia

2011 ◽  
Vol 2011 ◽  
pp. 1-2 ◽  
Author(s):  
Gabriel Vanerio
Keyword(s):  
Blood Pressure ◽  
Hiatal Hernia ◽  
Normal Sinus Rhythm ◽  
White Female ◽  
Loss Of Consciousness ◽  
X Ray ◽  
Normal Sinus ◽  
Carbonated Soft Drinks ◽  
Chest X Ray ◽  
Careful History

A 84-year-old white female had a brief loss of consciousness while playing bridge. A few minutes before the episode she had eaten pizza and significant amount of carbonated soft drinks. After recovery, her friends noticed that she was alert, but pale and sweating. Upon arrival at the emergency room, sitting blood pressure was 160/60 mmHg with a normal sinus rhythm. A chest X-Ray was performed, which was essential to make the diagnosis. The X-Ray showed a large retrocardiac opacity with air and liquid level compatible with a giant hiatus hernia. After a copious snack the hiatal hernia compressed the left atrium, decreasing the left cardiac output, elucidating the mechanism of the syncopal episode. In patients presenting with swallow syncope (particularly after a copious meal, validating the importance of a careful history), a chest X-Ray should be always be performed.

scholarly journals Giant hiatal hernia: beware of the supine ICU chest X-ray!

2017 ◽  
pp. bcr-2017-219668
Author(s):  
Vincent Bunel ◽  
Pierre Mordant ◽  
Lara Ribeiro ◽  
Bruno Crestani
Keyword(s):  
Hiatal Hernia ◽  
X Ray ◽  
Giant Hiatal Hernia ◽  
Chest X Ray

The Endgame

2021 ◽  
pp. 79-83
Author(s):  
Martha Gershun ◽  
John D. Lantos
Keyword(s):  
Blood Pressure ◽  
Glucose Tolerance ◽  
Kidney Function ◽  
Antihypertensive Medication ◽  
Salt Intake ◽  
Psychological Screening ◽  
X Ray ◽  
Blood Tests ◽  
Kidney Paired Donation ◽  
Chest X Ray

This chapter begins with detailing the author's final results following her three-day grueling tests for glucose tolerance, psychological screening, kidney function, EKG, and a chest X-ray. The author found out that there was an issue with her blood pressure. It then outlines the four available choices she could take: to end the process, to lose some weight and reduce salt intake and retest in a few months, to start on a very low dose of antihypertensive medication and retest in two weeks, and finally, to take her current results to the Transplant Selection Committee and hope for the best. Ultimately, the chapter presents an alternative plan, to become part of the Kidney Paired Donation program, if the new blood tests ruled the author unable to donate directly to the intended recipient.

Imaging in chronic cough in paediatrics

2011 ◽  
Vol 56 (4) ◽  
pp. 1-2
Author(s):  
S Brown ◽  
P Davies
Keyword(s):  
Clinical Features ◽  
Chronic Cough ◽  
History Taking ◽  
X Ray ◽  
Common Presentation ◽  
Chest X Ray ◽  
Careful History

Chronic cough is a common presentation in paediatrics. We describe a case which highlights the need for careful history taking and summarize the key clinical features which should prompt a clinician to perform a chest X-ray.

scholarly journals Intracardiac Migration of the Ureteral Double-J Stent during Percutaneous Nephrolithotomy

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 939
Author(s):  
Chun-Kai Chang ◽  
Yi-Hsuan Wu ◽  
Ming-Chen Paul Shih ◽  
Jiun-Hung Geng
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
X Ray ◽  
One Stage ◽  
Medical Issues ◽  
Double J Stent ◽  
Chest X Ray ◽  
To Receive

The complications of percutaneous nephrolithotomy (PNL) include hemorrhage, damage to adjuvant organs, and other medical issues, although intracardiac migration of ureteral double-J stent has never been found during PNL and delaying the diagnosis might cause mortality. We report the case of a 60-year-old male who was admitted to receive one-stage PNL for right renal stones. During operation, an unexpected atrial fibrillation with a drop in blood pressure was suddenly encountered and the chest X-ray subsequently showed that the ureteral double-J had penetrated deep into the heart. Emergent endovascular intervention was performed to remove the stent and the patient was uneventfully discharged 2 days later.

scholarly journals Incidental Hiatal Hernia on Chest X-ray

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Ahmed Farhat ◽  
Daryn Towle
Keyword(s):  
Hiatal Hernia ◽  
X Ray ◽  
Chest X Ray

Common Variable Immunodeficiency Revealed by a Chest X-Ray and Careful History

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 177A
Author(s):  
Shalin Kothari ◽  
Miruna Carnaru ◽  
Wajihuddin Syed ◽  
Amit Dhamoon
Keyword(s):  
Common Variable Immunodeficiency ◽  
X Ray ◽  
Chest X Ray ◽  
Common Variable ◽  
Careful History

Furazolidone-Induced Pulmonary Hypersensitivity

2005 ◽  
Vol 39 (2) ◽  
pp. 377-379 ◽  
Author(s):  
Todd J Kowalski ◽  
Michael J Henry ◽  
Jonathan A Zlabek
Keyword(s):  
Adverse Effect ◽  
Adverse Reaction ◽  
White Female ◽  
Hypersensitivity Reactions ◽  
Probability Scale ◽  
X Ray ◽  
Medline Search ◽  
Case Summary ◽  
Chest X Ray ◽  
Bactericidal Agent

OBJECTIVE: To report a case of pulmonary hypersensitivity associated with furazolidone use and review the literature on this topic. CASE SUMMARY: A 43-year-old white female presented with fever and dyspnea. She had recently completed a course of furazolidone 125 mg 4 times daily for 10 days for enteritis. Investigations revealed bibasilar interstitial infiltrates on chest X-ray, hypoxia, and 21% eosinophilia. Her fever, hypoxia, and dyspnea rapidly abated following discontinuation of furazolidone and administration of corticoteroids. DISCUSSION: Furazolidone is a bactericidal agent used to treat infectious enteropathies. It is chemically similar to nitrofurantoin, which is well known to cause pulmonary hypersensitivity reactions. Application of the Naranjo probability scale suggests that a furazolidone adverse reaction in this patient was probable. A MEDLINE search from 1966 to October 2004 revealed 2 previously reported cases suggestive of furazolidone pulmonary hypersensitivity. All published reports closely resemble each other and descriptions of nitrofurantoin-associated pulmonary hypersensitivity reactions. CONCLUSIONS: Furazolidone may induce pulmonary hypersensitivity reactions; clinicians should be aware of this potentially serious adverse effect.

scholarly journals Syncope triggered by atrial flutter in a patient with a pacemaker: cross-stimulation—a case report

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Olga Durán-Bobin ◽  
Francisco Crespo-Mancebo ◽  
Juliana Elices-Teja ◽  
Carlos González-Juanatey
Keyword(s):  
Sinus Rhythm ◽  
Atrial Flutter ◽  
Normal Sinus Rhythm ◽  
Pacemaker Implantation ◽  
P Waves ◽  
Normal Sinus ◽  
Surface Ecg ◽  
Patient Reported ◽  
Chest X Ray ◽  
High Degree

Abstract Background Syncope in a patient with a pacemaker is a serious event requiring urgent action to ascertain its cause. Around 5% of cases are due to a pacemaker system malfunction. Case summary An 82-year-old man underwent dual-chamber permanent pacemaker implantation due to intermittent high-degree atrioventricular block (AVB) in sinus rhythm. Nine months later, the patient reported episodes of syncope. The chest X-ray showed both leads to be at their expected positions. The electrocardiography (ECG) showed common atrial flutter. Ventricular capture during pacing in atrial demand pacing (AAI) mode confirmed cross-stimulation due to the switching of the atrial and ventricular leads at the pacemaker header. Discussion Cross-stimulation is a rare possibility in a differential diagnosis of causes of syncope. The diagnosis is frequently made during the procedure or a few hours later. The lack of symptoms during 9 months in this case was likely due to the patient having normal sinus rhythm with preserved AV conduction most of the time, as well as ventricular capture from the atrial lead related to non-sensed P waves. When atrial arrhythmias occurred, the sensing of the F waves inhibited ventricular pacing. In order to avoid this complication, in patients with intermittent bradycardia, pacing at a slightly higher heart rate during implantation of the device should be recommended to see the chamber paced with the surface ECG connected to the device interrogator. The ECG and electrogram (EGM) should correlate during device interrogation in order to identify this complication.)

scholarly journals The Association between Blunt Cardiac Injury and Isolated Sternal Fracture

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Anahita Dua ◽  
Jason McMaster ◽  
Pathik J. Desai ◽  
Sapan S. Desai ◽  
SreyRam Kuy ◽  
...  
Keyword(s):  
Normal Sinus Rhythm ◽  
Cardiac Injury ◽  
Sternal Fracture ◽  
Normal Sinus ◽  
Chest X Ray ◽  
Level I ◽  
Clinically Significant ◽  
The Uk ◽  
Sternal Fractures

The treatment of isolated sternal fractures (ISF) throughout the world is heterogeneous. This study aimed to identify the incidence, morbidity, and mortality associated with isolated fractures of the sternum and describe current practice for diagnosis and management of ISF and cardiac injury at a level I trauma center in the UK. A retrospective cohort study of adult patients (>16 years) with ISF presenting from 2006 to 2010 was conducted. Eighty-eight patients with ISF were identified. Most patients (88%, 77) were admitted to hospital with 66% (58) of them discharged within 48 hours. Two (2%) patients had an ER EKG with abnormality but both resolved to normal sinus rhythm within 6 hours of follow-up. Serum CEs were drawn from 55 (63%) patients with only 2 (2%) having a rise in serum troponin >0.04; however, in both of these patients troponin quickly normalized. Six (7%) patients underwent echocardiograms without significant findings. In all 88 patients with ISF, no cases of clinically significant cardiac injury were identified. Patients presenting with an isolated sternal fracture with no changes on EKG or chest X-ray do not warrant an admission to hospital and may be discharged from the ER.

scholarly journals A Large Intrathoracic Hiatal Hernia as a Cause of Complete Heart Block

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ali Abbood ◽  
Hareer Al Salihi ◽  
Jorge Parellada ◽  
Mario Madruga ◽  
S. J. Carlan
Keyword(s):  
Abdominal Pain ◽  
Gastroesophageal Reflux ◽  
Hiatal Hernia ◽  
Heart Block ◽  
Surgical Repair ◽  
Complete Heart Block ◽  
Normal Sinus Rhythm ◽  
Normal Sinus ◽  
Ventricular Response ◽  
The One

Hiatal hernia is a not uncommon anatomic disorder resulting in portions of the bowel occupying space in the thoracic cavity. There are a number of antecedent risk factors including obesity but not hiatal hernias resulting in symptoms. When symptoms do occur, they can include chest pain, nausea, abdominal pain, and gastroesophageal reflux. Cardiac arrhythmias have also been reported as associated conditions resulting from a hiatal hernia. To date, however, a complete heart block secondary to a hiatal hernia has not been reported. An 88-year-old female with a history of GERD (gastroesophageal reflux disease) was found to have a large hiatal hernia at endoscopy after she presented to the emergency department with nausea and abdominal pain. Prior to her scheduled surgical repair, she developed symptomatic third degree heart block which resolved with nasogastric tube deflation of the gastric contents. After surgical repair of the hiatal hernia, she developed episodes of atrial fibrillation with rapid ventricular response and was started on diltiazem. She eventually converted back to normal sinus rhythm and remained dysrhythmia free. In addition to other known arrhythmias associated with hiatal hernia, a complete heart block can also be seen. Acute management requires deflation of the chest occupying hernia. This appears to be the one of the first reported cases of complete heart block caused by hiatal hernia.

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