Aortic aneurysm with dysphagia

A 66-year-old male suffering from dysphagia with progressive severity of about three months’ duration was admitted to the Emergency department. During the last week, he had drooling and hoarseness. In the past week, he described two times of syncope. And he indicated chronic cough and mild sputum recently. An incidental chest radiography showed evidence of marked dilation of the aortic arch and deviation of trachea. Echocardiography revealed LVEF of 55% and a grade 1 left ventricular diastolic dysfunction. Also, aneurysmal dilation of thoracic aortic curve containing crescentric form thrombosis with calcification mostly suggestive of thrombosis within aneurysm was seen. With 100% stenosis of LAD, Major Diagonal and RCA, he was recommended for CABG. Aneurysm of the thoracic aorta is a very rare cause of dysphagia and it must be differentiated from other causes, since proper managements can significantly reduce the morbidity and mortality of this disease. Discussion Etiologies of esophageal dysphagia include neuromuscular disorders (such as achalasia and scleroderma), intrinsic structural lesions (like esophageal carcinoma, esophageal rings and webs and eosinophilic esophagitis) and extrinsic structural lesions (like mediastinal lesions and vascular compression).Aneurysm of the thoracic aorta is a very rare cause of dysphagia and it must be differentiated from other causes, since proper managements (like urgent surgical interventions if needed) can significantly reduce the morbidity and mortality of this disease. Treatment of dysphagia caused by aortic aneurysm can be conservative, surgical or palliative depending on the severity of the symptom. By accurate management, prognoses of the patients are almost always good. In coping with dysphagia, gastrointestinal disorders should not be the only complications that is payed attention and dysphasia must be considered as a rare sign of aneurysms. The case report on this rare cause should contribute to better diagnosis of dysphagia aortica and swallowing difficulties in general.