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26-10-2016 | Heart Beat | Uitgave 1/2017 Open Access

Netherlands Heart Journal 1/2017

A rare cause of excruciating chest pain mimicking acute coronary syndrome

Netherlands Heart Journal > Uitgave 1/2017
L. Hobohm, D. Krompiec, R. Michel, Y. Yang, F. Schmidt, C. Düber, T. Münzel, P. Wenzel
A 62 year-old male presented to the chest pain unit with chest pain and nausea, reporting that the symptoms occurred one hour after dinner. His medical history included a foudroyant event of pulmonary embolism with embolectomy in 2012.
Due to clinical deterioration and the history of pulmonary embolism, we decided to perform a contrast computed tomography angiography (CT). We could rule out aortic dissection and pulmonary embolism, However, CT revealed a mixed axial para-oesophageal upside-down stomach (UDS) compressing the left ventricle (Fig.  1).
UDS is the rarest type of hiatal hernia and can manifest clinically in a wide variety of symptoms as demonstrated in this case [ 1]. As causes of chest pain, gastrointestinal disease other than peptic ulcer or reflux-related diseases which might include UDS were reported to be below 1 % [ 2]. In UDS patients, complications such as incarceration, volvulus development as well as acute gastric bleeding can lead to a life-threatening emergency with prevalence of 30.4 % and can require immediate surgery [ 3, 4].

Conflict of interest

L. Hobohm, D. Krompiec, R. Michel, Y. Yang, F. Schmidt, C. Düber, T. Münzel and P. Wenzel declare that they have no competing interest.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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