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Official websites use. Share sensitive information only on official, secure websites. A Parasternal long-axis view before ingestion of carbonate d beverage, showing a retrocardiac mass-like lesion near the atrioventricular junction. A year-old female presented to the outpatient clinic with complaints of retrosternal pain. The electrocardiogram was normal. Exercise testing was within normal limits. Transthoracic echocardiography showed normal dimensions and normal valvular and ventricular function. A mass-like lesion was visible near the left posterior atrioventricular junction in all echocardiographic views figure 1A. Differential diagnosis included intracardiac thrombus, intracardiac tumour, extracardiac tumour, dilated descending aorta and hiatal hernia. Computed tomography CT of the thorax revealed a large hiatal hernia, extending far into the retrocardiac region figure 2. This diagnosis was confirmed by repeat echocardiography after having the patient drink a carbonated beverage in the recumbent position. Hiatal herna is a herniation of abdominal contents into the thoracic cavity through the diaphragmatic hiatus. It often results in gastro-oesophageal reflux, which in this patient was thought to be the cause of her retrosternal complaints at presentation. In retrospect, she had already been suffering from heartburn for years. In this case, the diagnosis of hiatal hernia was established by CT. Chest radiography was omitted, but could have resulted in this diagnosis as well, with a much lower radiation load. As of January , all manuscripts will undergo a fully automated submission and layout process. It is important that authors follow the instructions given in mail generated by the system carefully. We can no longer accept submissions via e-mail. The Instructions for Authors have also been amended. Please pay special attention to the requirements for tables and figures. Please be aware that articles that do not meet these requirements will not be accepted for review. As a library, NLM provides access to scientific literature. Neth Heart J. Find articles by FM van de Sandt. Find articles by CLA Reichert. Issue date Nov. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.
Here are the ticketing details for our UEFA Europa League league phase home fixture against AZ Alkmaar at Tottenham Hotspur Stadium on Thursday 24 October (8pm.
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