Left atrium compression due to oesophageal dilation can induce acute heart failure.

An 85-year-old woman reported sudden onset dyspnoea and subsequent vomiting after eating a large meal. She had normal blood pressure (124/60 mm Hg) but was tachypnoeic (28/min). Coarse crackles were heard in all the lung fields, and chest radiography showed congestion. ECG showed a non-specific ST-T change, and the brain natriuretic peptide level was 35.2 pg/mL. Transthoracic echocardiography demonstrated extrinsic left atrial (LA) compression (figure 1), and the tricuspid regurgitation pressure gradient was 42 mm Hg. Subsequently, contrast-enhanced CT revealed oesophageal dilation compressing the LA (figure …