Diagnostic dilemmas in dysphagia aortica

Abstract

Dysphagia aortica commonly coexists with motility disorders and GORD. Video solid bolus swallow allowed us to determine the clinical significance of a manometric HPB in 4 out of 5 patients suspected on dysphagia aortica where standard evaluation would have failed. We recommend its use in those patients with a manometric HPB suggestive of dysphagia aortica in whom standard barium swallow is normal.

Dysphagia in the aging cardiovascular patient

“…The incidence is rare, however, it appears predisposed to a variety of risk factors including female gender, older age, short stature, and spinal abnormalities such as kyphosis (2,3).…”

A Case of Dysphagia Aortica in an Elderly Patient

“…Dysphagia aortica develops primarily in women and is associated with short stature, old age, hypertension and kyphosis. In some cases, the impairment of esophageal movement owing to nerve compression and gastroesophageal reflux disease may be associated, and may explain the progression from the asymptomatic esophageal compression to dysphagia 3 . It has been reported that even in normal individuals, localized high-pressure areas are observed frequently in manometry, and most dysphagia aortica patients have only intermittent mild dysphagia symptoms 7 .…”

“…In manometry, local high-pressure bands with superimposed pulsation synchronous with the cardiac cycle are observed. However, such typical findings are non-specific, and inconsistent; some cases lack typical radiologic findings or endoscopic findings 3,11,13 . Although the barium swallow test is the gold standard for dysphagia aortica, false negative results are frequent because the test uses a liquid contrast medium 14 .…”

“…Moreover, dysphagia aortica appears commonly in association with gastroesophageal reflux disease or esophageal motility disorder and thus it is not easy to confirm the primary etiology of the dysphagia 3 .…”

“…The exact incidence rate of dysphagia aortica has not been established; however, it occurs rarely 2 and appears predisposed to women, old age, short stature, hypertension and kyphosis 3,4 .…”