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Hiatus hernia are usually an incidental finding if they are small as then it is likely not be symptomatic. However, once the size grows symptoms start manifesting in the form of chest discomfort, heart burns, sour eructations, nausea, heaviness, belching, chest pain, etc, which tend to become exaggerated when leaning forward, or when lifting or pushing on heavy weights. The retrocardiac hiatal hernia is a great mimic and can give rise to symptoms referred to heart and lungs, eg, chest pain, difficulty in breathing, asthma like symptoms, and could cause pressure over oesophagus to give rise to difficulty in swallowing. If undetected, symptoms due to complications may supervene like GERD, Barrett’s oesophagus, erosions, bleeding and anaemia, ischemia of gut that that may become impacted occasionally, etc.