1/5. Giant hiatal hernia presenting with stable angina pectoris and syncope--a case report.A 70-year-old woman with giant hiatal hernia presented with stable angina pectoris and three syncope attacks in the previous 3 months. Chest radiography showed marked cardiomegaly and an air-fluid level at the basal region of the heart. A mixed type large hiatal hernia that distorted the heart was detected in contrast-enhanced computed tomography and esophagogastroduodenography. Postprandial nonsustained ventricular tachycardia was present on 24-hour Holter ECG monitoring. The patient's symptoms were attributed to giant hiatal hernia and improved following surgery.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/5. Giant fibrovascular polyp of the esophagus. A lesion causing upper airway obstruction and syncope.Giant fibrovascular polyp of the esophagus is a rare but dramatic entity. These large polyps arise in the proximal esophagus and can cause airway obstruction secondary to mechanical pressure on the larynx, or they can present as a mass that is regurgitated into the oral cavity. We present a 66-year-old man who complained of nausea and vomiting that were associated with a fibrovascular polyp protruding into the mouth. He had also experienced several episodes of syncope resulting from intermittent airway obstruction. He underwent an open resection of an 11.8-cm fibrovascular polyp and an endoscopic resection of a second fibrovascular polyp 2 days later. Histopathologically, both masses were composed of a mixture of mature adipose tissue lobules and fibrovascular tissue, lined by reactive squamous epithelium. Despite their large size, giant fibrovascular polyps should be recognized radiologically and pathologically as benign lesions. However, they can result in significant morbidity.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
3/5. Giant cell myocarditis depicted by cardiac magnetic resonance imaging.Giant cell myocarditis is a rare condition, the cardiac magnetic resonance imaging findings of which have not been previously described. The disease usually occurs in young previously healthy people and is typified by rapidly progressive cardiac dysfunction, often requiring cardiac transplantation. A case of giant cell myocarditis is presented, with associated pathologic and imaging findings.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
4/5. Giant cell (temporal) arteritis presenting with syncope.Giant cell (temporal) arteritis presenting with syncope due to carotid sinus hypersensitivity is described. Although the association of giant cell (temporal) arteritis and carotid sinus hypersensitivity is known, there are no previous reports of syncope as the presenting feature of giant cell (temporal) arteritis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/5. A catheter-induced syncopal attack in a case of hypertrophic obstructive cardiomyopathy.A 48-year-old man with hypertrophic obstructive cardiomyopathy (HOCM) was studied by serial cardiac catheterization during incidentally induced syncope. His hospital admission was for repeated syncopal attacks and chest pain. His electrocardiogram showed giant negative T waves (greater than 10 mm) in V3, V4 and V5 leads, and his M-mode echocardiogram disclosed typical asymmetric septal hypertrophy, systolic anterior movement of the mitral valve, and a midsystolic semiclosure of the aortic valve. During cardiac catheterization, we incidentally induced syncope and recorded the serial pressure changes. During syncope, systemic blood pressure dropped without appreciable changes in pulmonary arterial and right ventricular pressures. Although blood pressure was maintained by administering etilefrine and hydrocortisone, syncope persisted. After administration of propranolol, he recovered from syncope. He was on sinus rhythm throughout the examinations. The ejection time (ET) obtained from the aortic pressure curve was extremely short (160 msec) during syncope and prolonged (300 msec) after recovery without significant change in the heart rate. We believe that the prompt intravenous administration of propranolol was very effective in relieving myocardial spasm as a possible cause of syncope.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |