Chilaiditi Syndrome in a Patient with Ischemic Heart Disease

Abstract

Chilaiditi syndrome is a rare condition incidentally found in radiography of the chest and abdomen. It may be associated with transient dyspnea and abdominal or chest pain. Herein, we present a man with ischemic heart disease who was incidentally found to have Chilaiditi sign.

A 65-year-old man, a known case of ischemic heart disease who had undergone percutaneous coronary intervention twice, the last of which was 10 months before, presented with dyspnea on exertion in the last week. On physical examination, he had no abnormal findings. A chest radiograph showed the interposition of a segment of the colon in between the liver and right hemidiaphragm, a condition called Chilaiditi sign. For the possibility of in-stent restenosis of the coronary arteries, the patient was visited by a cardiologist who followed the patient up and finally ruled out the diagnosis based on his clinical judgment, electrocardiography, and serum troponin. After 10 months of follow-up, the patient is doing well.

The presence of Chilaiditi sign may lead to a false-positive diagnosis of diaphragmatic hernia. Chilaiditi syndrome may cause transient dyspnea; however, persistent dyspnea on exertion in a patient with ischemic heart disease should primarily be attributed to cardiovascular causes rather than the Chilaiditi syndrome.