Palpitations after dinner
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A 76-year-old woman with rheumatoid arthritis, diabetes mellitus and hypertension presented with a 1-month history of palpitations that occurred only after she had eaten dinner. The sensation was felt at the center of the chest and lasted for 10 to 15 minutes after the meal. An electrocardiogram was unremarkable. A chest radiograph (Panel A) showed a mediastinal shadow (white arrowheads) lateral to the left heart border (black arrowheads). Computed tomography of the chest revealed a left diaphragmatic hernia (Panel B), with the stomach positioned in the thorax (Panel C, coronal view), abutting the left ventricle (Panel D, axial view, arrowheads). Gastric endoscopy revealed a volvulus, with a twisting of the mucosa.Surgical repair of a hernia and volvulus done...

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Dr. M●. S●●●●●l I●●●m S●●●n and 22 others like this
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