When the Heart Triggers the Esophagus: Esophageal Spasm after Electrical Cardioversion

INTRODUCTION: “Esophageal spasm” is a generic term widely used to attribute unexplained non-cardiac chest pain and/or dysphagia to an esophageal motility disorder. PATIENT AND METHODS: The authors present the case of an 86-year-old male patient with complete dysphagia after an elective electrical cardioversion for atrial fibrillation. An upper endoscopy performed shortly after the onset of the clinical picture documented disordered esophageal contractions. The patient became asymptomatic within 12 hours of the administration of a spasmolytic therapy. RESULTS: To the best of our knowledge, this is the first report of esophageal spasm after an electrical cardioversion. DISCUSSION: The temporal correlation supports the explanation of a cause-effect relationship between the clinical presentation and the preceding procedure, thus providing elements for clinicians to recognize and treat this particular condition. LEARNING POINTS: This case report suggests that electrical cardioversion may induce clinically relevant esophageal spasms. When dealing with dysphagia after an electrical cardioversion, an empirical spasmolytic treatment can be considered, if not contraindicated.