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Case Reports in Cardiology
Volume 2011 (2011), Article ID 560734, 2 pages
http://dx.doi.org/10.1155/2011/560734
Case Report

Syncope Caused by Huge Hiatal Hernia

Intensive Care Unit and Cardiology Departments, British Hospital Montevideo, 2420 Avenue Italia, 11600 Montevideo, Uruguay

Received 19 June 2011; Accepted 18 July 2011

Academic Editors: R. Akdemir and T. Tak

Copyright © 2011 Gabriel Vanerio. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.