Abstract
Background Several clinical entities may be misdiagnosed in elderly if we consider dysphagia as a normal aging process in our daily practice. On top of usual aetiologies like motor dysfunction, investigations may uncover serious underlying conditions.
Case summary We report an unusual case where dysphagia was the warning sign for acute heart failure in a 76-year-old patient known to have dilated cardiomyopathy with reduced ejection fraction. It was due to an external oesophageal compression by the left atrium. A transthoracic echocardiography, an enhanced thoracic computed tomography-scan and esophagogastroduodenoscopy were used for the diagnosis. Diuretics were the cornerstone treatment with symptomatic improvement.
Discussion Despite the fact that cardiovascular dysphagia is an uncommon medical entity, but it remains a potential differential diagnosis, especially in elderlies with high risk for atrial enlargement.