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Posts Tagged ‘rare causes of atrial arrhythmias’

Logic would suggest  any two structures  in close proximity can have  some sort of anatomical , physiological or sometimes pathological relationship .Esophagus and heart  share a strategic  anatomical  space within the mediastinum  . The left atrial wall  is abetting the esophagus with only few millimeters separating the two. Trans esophageal  echocardiography has utilised this proximity for it’s  advantage . With the probe in esophagus we can get a  100%  interior view of left atrium . Both these structures can mutually compress one another at times of pathology . ( LA compression on esophagus in mitral stenosis , Esophageal compression of LA in hiatus hernia or esophageal growths) . Now ,  we also  realise , esophagus  a   functionally unrelated structure  to  cardiovascular system  can have a impact on cardiac functioning.

Hiatus hernia of gastroesophageal junction can mechanically compress the posterior aspect of heart and result in atrial  arrhythmias and pericarditis  ?

Reference

1 Duygu H, Ozerkan F, Saygi S, et al. Persistent atrial fibrillation associated with
gastroesophageal refl ux accompanied by hiatal hernia. Anadolu Kardiyol Derg
2008; 8(2):164-165.

A case report from South africa

http://www.saheart.org/journal/index.php?journal=SAHJ&page=article&op=view&path[]=115&path[]=109

Read further for esophagus- heart  stories.

  • Esophageal ulcers , spasm can trigger electrical activity that can mimic cardiac event  or rarely precipitate a real angina  , what is often referred to as  linked angina .
  • A rare case of pneumopericardium due to rupture of esophagus into pericardial space
  • ST elevation in ECG due to esophageal spasm

http://www.drsvenkatesan.com

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