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.