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Articles

Title: Isolated intrathoracic hiatal colonic hernia mimicking acute coronary syndrome ? a case report

Author:
Michał Plewka, Jan Z. Peruga, Łukasz Chrzanowski, Michał Kidawa, Jarosław D. Kasprzak
Type:
Review articles
Language:
PL
Journal:
Polish Journal of Cardiology
Year:
2010
Volume:
12
Number:
2
Start page:
161
Final page:
163
ISSN:
1507-5540
Keywords:
hiatal colonic hernia, acute coronary syndrome
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76-years-old woman was admitted to the Cardiology Department because of recurrent severe chest pain and dyspnea since two days with initial diagnosis of acute coronary syndrome. Medical history included chronic stable coronary artery disease, hypertension, and gastroesophageal reflux disease. Coronary angiography performed 12 months earlier showed three-vessel coronary artery disease, with long, calcified, up to 95% lesions, involving distal segments. She was disqualified from percutaneous coronary intervention and surgical treatment. An electrocardiogram on admission showed 1 mm ST-segment depression in leads I, aVL, V3-V6 and echocardiography anterior and inferior wall hypokinesis, with left ventricular ejection fraction 38%. Troponin T was borderline elevated. Coronary angiography revealed no disease progression compared to the previous examination. During the coro- nary angiography chest fluoroscopy revealed unexpected finding of massive translocation of colon loop into the mediastinum through the esophageal hiatus. The patient underwent urgent surgery with Nissen procedure. The postoperative clinical course was uneventful. The patients received medical treatment of coronary artery disease without recurrence of symptoms.