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ARTICLE |

Sudden Dysphagia in Acute Myocardial Infarction FREE

Juhani Heikkilä, MD; Kimmo LUOMANMAKI, MD; Mauri Wiljasalo, MD
JAMA. 1971;217(10):1390-1391. doi:10.1001/jama.1971.03190100072020
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To the Editor.—  Difficulties in swallowing are rarely caused by cardiovascular diseases. In patients with chronic mitral valvar lesions such symptoms have occasionally resulted from direct mechanical compression of the esophagus by the elevated pressure in the dilated left atrium.1 In a patient with sudden and complete esophageal obstruction, total inability to swallow showed a close and reversible connection with paroxysms of atrial fibrillation. A radiological study verified compression of the lower esophagus by the heart. Acute left heart failure secondary to extensive myocardial infarction as the cause has apparently not been observed.

Report of a Case.—  A 60-year-old carpenter was healthy until a mild angina pectoris appeared ten months prior to admission. At the intensive care unit of this hospital he complained of acute pains in the chest and breathlessness. An extensive fresh anterior myocardial infarction was shown by the electrocardiogram (Figure). The enzyme levels were high; serum

REFERENCES

Bellet S:  Interrelationship of cardiovascular and gastrointestinal disorders , in Bockus HL (ed): Gastroenterology , ed 2. Philadelphia and London, WB Saunders, Co, 1965;, vol 3, p 1168.
Evans W: Diseases of the Heart and Arteries . Edinburgh and London, E & S Livingstone, 1964;.
Russell RO Jr, Rackley EC, Pombo Ramos JF, et al:  Effects of increasing left ventricular filling pressure in patients with acute myocardial infarction . Amer J Cardiol 25:125, 1970;.
Grainger RG:  Pulmonary hypertension: A symposium: III. Interstitial pulmonary oedema and its radiological diagnosis: A sign of pulmonary venous and capillary hypertension . Brit J Radiol 31:201-216, 1958;.
McHugh TJ, Adler L, Zion D, et al:  Acute myocardial infarction: Radiologic, clinical and hemodynamic correlations . Circulation 42( (suppl 3) ):31, 1970;.
Cobbs BW Jr:  Clinical recognition and medical management of rheumatic fever and valvular heart disease , in Hurst JW, Logue RB (eds): The Heart . New York, McGraw-Hill Book Co, 1966;, p 560.
Heikkilä J:  Mitral incompetence as a complication of acute myocardial infarction . Acta Med Scand 182( (suppl 475) ):1-149, 1967;.
Texter EC Jr, Chou C-C, Laureta HC, et al: Physiology of the Gastrointestinal Tract . St. Louis, CV Mosby, 1968;.
Shapiro W, Klein G:  Alterations in cardiac function immediately following electrical conversion of atrial fibrillation to normal sinus rhythm . Circulation 38:1074-1084, 1968;.

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Bellet S:  Interrelationship of cardiovascular and gastrointestinal disorders , in Bockus HL (ed): Gastroenterology , ed 2. Philadelphia and London, WB Saunders, Co, 1965;, vol 3, p 1168.
Evans W: Diseases of the Heart and Arteries . Edinburgh and London, E & S Livingstone, 1964;.
Russell RO Jr, Rackley EC, Pombo Ramos JF, et al:  Effects of increasing left ventricular filling pressure in patients with acute myocardial infarction . Amer J Cardiol 25:125, 1970;.
Grainger RG:  Pulmonary hypertension: A symposium: III. Interstitial pulmonary oedema and its radiological diagnosis: A sign of pulmonary venous and capillary hypertension . Brit J Radiol 31:201-216, 1958;.
McHugh TJ, Adler L, Zion D, et al:  Acute myocardial infarction: Radiologic, clinical and hemodynamic correlations . Circulation 42( (suppl 3) ):31, 1970;.
Cobbs BW Jr:  Clinical recognition and medical management of rheumatic fever and valvular heart disease , in Hurst JW, Logue RB (eds): The Heart . New York, McGraw-Hill Book Co, 1966;, p 560.
Heikkilä J:  Mitral incompetence as a complication of acute myocardial infarction . Acta Med Scand 182( (suppl 475) ):1-149, 1967;.
Texter EC Jr, Chou C-C, Laureta HC, et al: Physiology of the Gastrointestinal Tract . St. Louis, CV Mosby, 1968;.
Shapiro W, Klein G:  Alterations in cardiac function immediately following electrical conversion of atrial fibrillation to normal sinus rhythm . Circulation 38:1074-1084, 1968;.
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To understand the clinical management of acute heart failure syndromes.
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