Heart failure induced by the restrictive left ventricle due to hiatus hernia
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A 76-year-old woman presented with shortness of breath and dyspnea after the intake of meals. Chest X-ray showed pulmonary congestion and pleural effusion. Computed tomography disclosed a hiatus hernia. Echocardiography demonstrated that the motion of the posterior wall in the left ventricle (LV) was paradoxically by the hiatus hernia, although LV ejection fraction was preserved. The restriction of LV by hiatus hernia could cause heart failure and open surgical repair of the hiatus hernia was performed. Dyspnea after the intake of meals disappeared and no recurrence of heart failure was observed in the subsequent period of several years.
KeywordsHeart failure Hiatus hernia Echocardiography Restriction Paradoxical motion
Conflict of interest
There are no financial or other relations that could lead to a conflict of interest.
Movie A: Echocardiogram, apical long-axis view. A hiatal hernia protrudes into the left ventricle on its posterior aspect. The posterior wall moves paradoxically, although left ventricular ejection fraction is preserved (AVI 1283 kb)
Movie B: An apical long-axis view in the echocardiogram after surgery. A hiatal hernia disappears. The diastolic wall motion of the left ventricle improves (AVI 1552 kb)