Is hiatus hernia mimicking Unstable angina ?

A 75 year old male , Farmer by occupatipn came with chief complaint of Chest pain , Cough ®urgitition since 3 years which all are assiciated after meals History Known case of Diabetes , asthma , hypertension . Chronic tobacco chewer Diagnosed for unstable angina when he went for complaint of chest pain & angiography suggested insignificant stenosis Physical Examination Bp elevated 140/80 mm of Hg Other vitals & examinations are normal Investigations Upper GI endoscopy has found Hiatus Hernia type 3 with sliding Component Diagnosis Haitus hernia Management Fundoplication was done - Nissens 360 wrap Now should we consider having unstable angina as angiography suggested insignificant stenosis?

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You can go to 2D echo for investigation of chaice to look cad Needs clinically correlation Nutritional supplements Adequate hydration Maintenance of electrolytes balance Might be helpful 👍

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Stenosis as not relieved by vasodilators and he is a c/o multiple comorbidies having unstable angina mimicking with haitus hernia the issue is settled hence go for repeating angiography and angioplasty

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Yes it's quite possible to misdiagnose hiatus hernia as angina owing to similarities in symptoms like chest tightness, dyspea/DOE, orthopnoea. Similar appearance (possibly enlarged cardiac silhouette) on bedside radiographs of chest could also make diagnosis difficult. Endoscopy/CT is usually helpful. It's specially difficult in patients having predisposing conditions to heart diseases like obesity - with such symptoms first suspicion goes towards a cardiovascular cause.

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Yes, It can Needs proper evaluation and treatment Better to go for surgery (fundoplication)

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K/C/O DM-2/BA/HTN/CVD & HIATUS HERNIA TYPE-3 ,, P/H/O:- UNDERWENT ANGIOGRAPHY WHICH SHOWED INSIGNIFICANT STENOSIS. P/H/O:- FUNDOPLICATION WAS DONE WITH NISSENS 360 WRAP . IN MY VIEW,,, DON'T CONSIDER IT MUCH (UNSTABLE ANGINA) AS ANGIOGRAPHY ALREADY SUGGESTED INSIGNIFICANT STENOSIS. CHEST PAIN CAN BE DUE TO REFLUX ALSO ,,,DUE TO HIATUS HERNIA ALSO. TAKE AN OPINION OF DM CARDIOLOGIST FOR BETTER MANAGEMENT. SYMPTOMATIC TREATMENT WITH CLINICAL CORRELATION.

APD

Pardon ,I did not understand
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