Dysphagia or difficulty swallowing means using more effort to move solids or liquids from the oropharynx to the stomach. Dysphagia is classified into two types, oropharyngeal and esophageal dysphagia. They can either be caused by mechanical obstructions or by neuromuscular motility disorders. Here, we report the case of a 66-year-old male patient, who presented with progressive
dysphagia as the main manifestation. He underwent multiple investigations and incidentally was diagnosed with an Aortic Aneurysm.Case report:66-year-old male suffering from painful swallowing was admitted to the Emergency Department. He complained of throat discomfort,
dysphagia and odynophagia of progressive severity of about three months’ duration, which was not related to cold or warm food. On admission, the patient was completely alert and cooperative. On measuring his vital signs, blood pressure of 134/77 mmHg, pulse rate of 70 beats per minute, respiratory rate of 18 breaths per minute and SPO2 of 97% were reported. No pathological sign in the oral cavity or pharynx and tongue mobility and strength was found. During a three months period, different tests and evaluations were performed. No significant finding was seen in the EKG or the EMG-NCV evaluations. Incidental chest radiography showed evidence of marked dilation of the aortic arch and deviation of the trachea. All lab tests were normal except for Hemoglobin which was 15.2 g/dl in the first day of admission but 12.5 g/dl three days later. Echocardiography was performed and an LVEF of 55% and a grade 1 left ventricular diastolic dysfunction were reported. Also, aneurysmal dilation of the thoracic aortic curve (96mm × 88mm) containing crescent-shaped thrombosis together with calcification (46mm × 80mm) mostly suggestive of thrombosis within aneurysm was seen. With a diagnosis of three-vessel disease (100% stenosis of LAD, Major Diagonal and RCA) he was recommended for CABG. Unfortunately, the patient passed away 7 days after admission while undergoing preparations for the treatment.Discussion and Conclusion In coping with dysphagia, gastrointestinal disorders should not be the only complications that are paid 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.