Dysphagia Aortica: A Rare Presentation of Infrarenal Abdominal Aortic Aneurysm in an Elderly Patient.

This article explores the challenges in diagnosing dysphagia aortica through the case of an 89-year-old man with a medical history of hypertension, ischemic heart disease, and chronic kidney disease. Over a three-month period, the patient experienced progressively worsening dysphagia and indigestion. On the day of presentation, his condition further deteriorated, marked by hypotension. Point-of-care ultrasound (POCUS) identified a large infrarenal abdominal aortic aneurysm (AAA) measuring 13 cm, which was later confirmed by CT to involve dissection and a contained rupture. This case highlights the rare presentation of dysphagia secondary to an infrarenal AAA, known as dysphagia aortica, emphasizing the importance of considering AAAs in elderly patients with vague gastrointestinal symptoms. Despite prompt diagnosis and referral for vascular surgery, the patient's prognosis was poor due to advanced age, frailty, and multiple comorbidities. Unfortunately, he passed away a few hours after presenting to the emergency department. This article underscores the critical role of imaging modalities such as POCUS and CT in identifying life-threatening conditions like AAAs, and it advocates for a comprehensive differential diagnosis in older adults while also serving as a reminder of the atypical presentations of AAAs.