Abstract
An 84-year-old female had been regularly consuming normal meals, and had not experienced either vomiting or dysphasia. She suddenly complained of dyspnea and respiratory stridor. A chest radiograph revealed an enlargement of the upper mediastinum. The patient was thereafter transported to the ICU at Fukuoka University Hospital for treatment. The patient presented with tachycardia, arrhythmia, tachypnea, respiratory stridor and jugular venous distention at the time of admission. Chest Computed Tomography revealed an abnormal dilation of the esophagus and a large amount of residue, thus leading to a diagnosis of esophageal achalasia. Tracheal intubation was performed because an abnormal dilation due to the esophageal airway obstruction caused by tracheal compression. This induced ventricular fibrillation, which required chest compression. Spontaneous circulation returned approximately 1 minute later, and emergency upper gastrointestinal endoscopy was then performed to release the pressure. The aspiration of aproximately 600 g of food residue from the esophagus caused the cardiac arrhythmia to subside, and the patient thereafter recovered from the shock. Subsequently, her general condition became stabilized. Esophageal achalasia must therefore be recognized as a disease that can sometimes be complicated with cardiac arrest.
