Dysphagia Secondary to Esophageal Compression in a Patient with Decompensated Heart Failure

• Published in: The Korean Journal of Helicobacter and Upper Gastrointestinal Research Vol. 22; no. 2; pp. 146 - 151
• Main Authors: Park, Jintae, Baek, Sora, Kim, Gowun, Nam, Seung-Joo, Cho, Byung-Ryul
• Format: Journal Article
• Language: English
• Published: Yong Chan Lee 01.06.2022; 대한상부위장관ㆍ헬리코박터학회
• Subjects: cardiomegaly; deglutition disorders; esophageal diseases; heart failure; manometry; 내과학
• ISSN: 1738-3331; 2671-826X
• DOI: 10.7704/kjhugr.2022.0008

Cardiogenic dysphagia is a rare type of esophageal dysphagia caused by external compression of the esophagus by an enlarged left atrium. Long-term comparisons between the degree of cardiogenic dysphagia and heart failure have not been reported due to its low incidence. We hereby report the case of a 74-year-old woman with valvular heart disease, suspected of having oropharyngeal dysphagia following a recent intracerebral hemorrhage, who performed a swallowing function test. Videofluoroscopic swallowing study (VFSS) revealed a supraglottic penetration, confirming the oropharyngeal dysphagia. Furthermore, post-VFSS chest radiograph revealed esophageal residual barium, suggestive of reduced esophageal food transition secondary to external compression, at the level of the T6 vertebral body. Chest computed tomography showed mid-esophageal compression caused by left atrial enlargement. She had pulmonary edema which was managed with diuretics. Post-VFSS chest radiographs also revealed a direct association between the diameter of the esophageal barium residue and body weight. A reduction in body weight led to the resolution of the barium residue and vice versa. Development of cardiac dysphagia may be one of the signs of acute exacerbation of heart failure.