Zusammenfassung
Wir berichten über eine 77-jährige Patientin mit Verdacht auf eine kardiale Raumforderung und beidseitiger, phlebographisch gesicherter Beinvenenthrombose mit multiplen Lungenembolien. Mittels transthorakaler und transösophagealer Echokardiographie sowie CT konnte eine intrakardiale Raumforderung ausgeschlossen werden. Es fand sich eine Hiatushernie, die den linken Vorhof von extrakardial komprimierte. Als echokardiographische Kriterien für Hiatushernien, wie von D’Cruz beschrieben, zeigte sich in diesem Fall eine Ausfüllung des linken Vorhofes durch eine solide Masse und ein atemabhängiger Wechsel des Ausmaßes der Kompression des Vorhofes. Aufgrund der geringen Inzidenz kardialer Raumforderungen sollte bei Verdacht auf eine solche eine Differenzialdiagnostik durchgeführt werden, wobei eine Hiatushernie stets in Betracht zu ziehen ist.
Abstract
A 77-year-old female presented with a suspected cardiac tumor and thrombosis of both legs diagnosed by phlebography with pulmonary embolism of both sides. In transthoracic echocardiography, transesophageal echocardiography, and CT no intracardial tumor was seen. There was a hiatal hernia which compressed the left atrium from outside. As echocardiographic criteria of hiatal hernia described by D’Cruz we found the left atrium filled with a solid mass and variation of compression of the left atrium depending on breathing. Because of the low incidence of cardiac tumors, differential diagnosis should be done if a cardiac tumor is suspected. A hiatal hernia should always be taken into consideration.
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Bandorski, D., Hönscher, R., Ibing, R. et al. 77-jährige Patientin mit Verdacht auf eine linksatriale Raumforderung. Internist 45, 1047–1052 (2004). https://doi.org/10.1007/s00108-004-1251-2
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DOI: https://doi.org/10.1007/s00108-004-1251-2