Esophageal cancer presenting with atrial fibrillation: a case report

IntroductionAtrial fibrillation was previously reported in patients with esophageal cancer as a complication of total esophagectomy or photodynamic therapy. Here, we propose that atrial fibrillation may also be caused by external compression of the left atrium by esophageal cancer.Case presentationWe present a 58-year-old man who developed atrial fibrillation with rapid ventricular rate in the emergency room while being evaluated for dysphagia and weight loss.

Atrial fibrillation lasted less than 12 hours and did not recur. Echocardiogram did not reveal any structural heart disease.

A 10-cm, ulcerated mid-esophageal mass was seen during esophagogastroscopy. Microscopic examination showed squamous cell carcinoma.

Computed tomography of the chest revealed esophageal thickening compressing the left atrium.

Conclusion: External compression of the left atrium was previously reported to provoke atrial fibrillation. Similarly, esophageal cancer may precipitate atrial fibrillation by mechanical compression of the left atrium or pulmonary veins, triggering ectopic beats in susceptible patients.

Author: Ulas Darda Bayraktar, Alix Dufresne, Soley Bayraktar, Ofem IbiahRoland Royston Purcell and Ofem Ibiah Ajah
Credits/Source: Journal of Medical Case Reports 2008, 2:292

Published on: 2008-09-08

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