Question: A 78-year-old woman was referred to our Gastroenterology unit because of deteriorating chronic reflux symptoms and increasing dyspnea. She had a long clinical history of mild pyrosis and regurgitation. In fact, after an esophagogram, the diagnosis given by her family physician was a hiatal hernia from which he had been suffering for a considerable time. Reflux symptoms were worse by night. After a complete interview, although she had been referred to our unit because of the worsening condition of her mild chronic reflux symptoms, she recognized that her main clinical complaint was her increasing dyspnea, which had been more severe in the previous 6 months. (Source: Gastroenterology)