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Recurrent Hiatal Hernia Resulting in Rightward Mediastinal Shift: Diagnostics in Cardiology and Clinical Pearls
- Source :
- Cureus
- Publication Year :
- 2021
- Publisher :
- Cureus, Inc., 2021.
-
Abstract
- On radiographic imaging, the finding of a right-sided heart location can be due to multiple etiologies and may be congenital or acquired. We present the case of a 71-year-old male with a self-reported past medical history of hiatal hernia and previously diagnosed dextrocardia. The patient experienced cardiovascular intervention following an ST-elevation myocardial infarction. In the cardiac workup, a low-voltage normal electrocardiogram confirmed dextroposition of the heart due to significant herniation of gastric contents into the thoracic cavity. This gentleman had presumably been diagnosed with dextrocardia, a right-left reversal of heart anatomy and electrophysiology, based on imaging and incomplete workup. Dextroposition refers to a rightward shift of the mediastinum with no changes in orientation of cardiac anatomy, and therefore unchanged directional orientation of conduction. This is an important distinction from dextrocardia, a mirror-image reversal of the cardiac chambers and heart location in the chest wall, such as that due to congenital ciliary dysfunction. A sliding hernia is an uncommon cause of the rightward mediastinal shift, with few such cases documented in the literature, and cardiovascular manifestations of hiatal hernias are discussed. This case exemplifies the role of an electrocardiogram in distinguishing between dextrocardia and dextroposition for accurate diagnosis and management.
- Subjects :
- Dextrocardia
medicine.medical_specialty
Past medical history
Thoracic cavity
business.industry
Mediastinal Shift
Cardiology
Gastroenterology
General Engineering
Mediastinum
electrocardiogram
dextroposition
medicine.disease
Hiatal hernia
medicine.anatomical_structure
cardiac compression
Internal medicine
Internal Medicine
medicine
Etiology
Myocardial infarction
business
dextrocardia
hiatal hernia
Subjects
Details
- ISSN :
- 21688184
- Database :
- OpenAIRE
- Journal :
- Cureus
- Accession number :
- edsair.doi.dedup.....d4efb7ab45739d5cb0de6a1a2a5720ab