Esophageal compression of the heart presenting as an extracardiac mass on echocardiography

Echocardiography is helpful in the identification of extracardiac masses. The role of echocardiography in evaluating the effects of the masses on the heart is not well established. The case presented details the identification of and the evaluation by echocardiography of structural and functional effects of a massively dilated esophagus on the heart. Two-dimensional echocardiography revealed anatomic distortion due to a mass effect of the dilated esophagus on the left heart chambers. M-mode echo recordings demonstrated decreased left atrial and ventricular dimensions with increased atrial and ventricular fractional shortening. These findings normalized after Heller myotomy, without a change of estimated stroke volume.