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Year : 2014  |  Volume : 24  |  Issue : 2  |  Page : 57-59

Three-dimensional trans-thoracic echocardiography of esophageal achalasia: Description of a case

Department of Internal Medicine and Geriatry, Second University of Naples, Naples, Italy

Correspondence Address:
Federico Cacciapuoti
Department of Internal Medicine and Geriatry, Second University of Naples, Piazza L. Miraglia, 2, 80138-Naples
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2211-4122.135619

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Esophageal achalasia is a motility disorder characterized by impaired relaxation of the lower esophageal sphincter and dilatation of the distal two-thirds of the esophagus. This condition may be a non-frequent reason of extrinsic compression of left atrium. In turn, this can be a cause of some hemodynamic changes such as chest discomfort, dyspnea or reduced exercise tolerance, systemic hypotension and tachycardia. We describe a case of a patient with esophagus achalasia compressing the left atrium and inducing hemodynamic compromise. The diagnostic methods, as chest X-ray, computed tomography (CT), manometry, and 2D-Trans-Thoracic Echocardiography (TTE) demonstrated the esophagus dilation, the impaired relaxation of the lower esophageal sphincter, and its compression on the left atrium. Three-D Trans-Thoracic Echocardiography (3D-TTE) was firstly performed also. This last examination pointed out better than 2D-TTE the extrinsic compression of the left atrium due to the esophagus dilatation. Therefore, 3D-TTE is a true improvement for the echocardiographic diagnosis of the left atrial compression induced by esophageal achalasia.

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