Echocardiography as an Initial Diagnostic Tool for Rare Extra Cardiac Diagnosis- Idiopathic Achalasia

Achalasia Transthoracic echocardiography Extra cardiac manifestation Georgia

Authors

  • Ketevan Lartsuliani, MD, PhD Doctor of Medical Sciences, Professor, Doctor Cardiologist, Echocardiologist at Aversi Clinic, Tbilisi, Georgia., Georgia
  • Lali Patsia, MD, PhD Doctor Cardiologist at Tbilisi State Medical University First University Clinic, Tbilisi, Georgia., Georgia
  • Nodar Sulashvili, MD, PhD Doctor of Theoretical Medicine In Pharmaceutical and Pharmacological Sciences, Invited Lecturer (Professor) of Scientific Research-Skills Center at Tbilisi State Medical University, Professor of Pharmacology of Faculty of Medicine at National University SEU, Associate Professor of Medical Pharmacology of Faculty of Medicine at Sulkhan-Saba Orbeliani University, Associate Professor of Division of Pharmacology of International School of Medicine at Alte University; Associate Professor of Pharmacy Program at Shota Meskhia Zugdidi State University; Associate Professor of Medical Pharmacology at School of Medicine at David Aghmashenebeli University of Georgia, Associate Professor of Biochemistry and Pharmacology Direction at the University of Georgia, School of Health Sciences. Associate Professor of Pharmacology of Faculty of Medicine at East European University, Associate Professor of Pharmacology of Faculty of Dentistry and Pharmacy at Tbilisi Humanitarian Teaching University; Tbilisi, Georgia; Researcher of Department of Pharmaceutical Management of Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia., Georgia
Vol. 3 No. 06 (2024)
Case Report
September 15, 2024

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Transthoracic echocardiography (TTE) is a noninvasive initial imaging modality in evaluating the anatomic structure and function of the heart. Although the diagnostic coincidence rate of TTE is slightly lower than that of computer tomography (CT) and magnetic resonance tomography (MRT), TTE has certain diagnostic value for extra-cardiac lesions. We report about a very rare and interesting finding observed using TTE study. Our case shows the role of TTE in identifying extra cardiac structure leading to the new important diagnosis and deferent treatment strategy.

61-year-old male patient was admitted to the hospital with main complaints: chest pain, dyspnea, cough, also he had dysphagia and weight loss. First of all, cardiologic examination has been done, TTE revealed left atrial (LA) compression by an inhomogeneous mass and accelerated flow in LA. TTE provided useful information of the location, size, echogenicity of the extra cardiac structure and its relationship with the heart. Esophageal pathology was suspected, the patient had been subjected to X-ray examination with barium and then an endoscopy. The result of which was confirmed diagnosis of idiopathic achalasia.

Our case shows the role of routine TTE in identifying extra cardiac structure - esophageal achalasia, leading to important extra cardiac diagnosis and indication for further surgical intervention.

Incidental echocardiographic extra cardiac findings in the clinical case presented by us led to a new diagnosis, referral of patients to surgeons and, accordingly, changed the treatment strategy.

Thus, it is very important to train, improve knowledge, focus on extra cardiac manifestations on echocardiography and establish appropriate guidelines for conducting a comprehensive study.