International Journal of Clinical & Medical Images

Clinical Image: Roemheld syndrome (RS), also known as gastric-cardia, is a syndrome where abnormalities in the gastrointestinal tract are found to be associated with cardiac symptoms like arrhythmias and palpitations, in the context of a normal cardiac workup. The underlying mechanism is that the mechanical pressure from GI organs on the heart reduces the cardiac filling, as well as causes compression of the vagus nerve leading to rhythm abnormalities. This case is regarding a 49 years old female with a large para-esophageal hiatal hernia (Figure 1 and 2) who developed paroxysmal atrial fibrillation. Patient was treated temporarily with rate control medications and anticoagulation and finally underwent hernia repair with complete resolution of atrial fibrillation