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Posterior cardiac compression from a large hiatal hernia—A novel cause of ventricular tachycardia
Sonali R. Gnanenthiran, MBBS, FRACP, Christopher Naoum, MBBS, FRACP, PhD, Michael J. Kilborn, MBBS, FRACP, PhD, FHRS, John Yiannikas, MBBS, FCCF, FACC, FESC, FCSANZ, FRACP HeartRhythm Case Reports Volume 4, Issue 8, Pages (August 2018) DOI: /j.hrcr Copyright © Terms and Conditions
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Figure 1 Electrocardiogram: ventricular tachycardia.
HeartRhythm Case Reports 2018 4, DOI: ( /j.hrcr ) Copyright © Terms and Conditions
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Figure 2 Transthoracic echocardiography: 4-chamber and 2-chamber views, preoperative (A, B) and postoperative (C, D). Preoperative views demonstrating left atrial compression (red arrow) and dyskinesis of the basal inferior left ventricular wall on resting echocardiography, with such changes resolving post hernia repair. HeartRhythm Case Reports 2018 4, DOI: ( /j.hrcr ) Copyright © Terms and Conditions
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Figure 3 Proposed mechanism of ventricular tachycardia (VT) secondary to posterior cardiac compression from a large hiatal hernia (long axis view). A: The mitral annulus is a saddle-shaped continuous fibrous ring that is adjacent to the aortomitral continuity (AMC). B: Direct posterior cardiac compression from the hiatal hernia (black arrows) may have resulted in indirect distortion of the anterior mitral annular annulus and/or the basal left septum (blue arrows), aggravating the propensity to VT. HeartRhythm Case Reports 2018 4, DOI: ( /j.hrcr ) Copyright © Terms and Conditions
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Supplemental Figure 1 ECG pre hiatal hernia repair.
HeartRhythm Case Reports 2018 4, DOI: ( /j.hrcr ) Copyright © Terms and Conditions
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Supplemental Figure 2 ECG post hiatal hernia repair.
HeartRhythm Case Reports 2018 4, DOI: ( /j.hrcr ) Copyright © Terms and Conditions
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