Recurrent choking as a presenting feature of aortic arch

Am J Emerg Med · May 2012

Case Reports

Recurrent choking as a presenting feature of aortic arch aneurysm.

Aortic arch aneurysm occurs more commonly in the aging population. Rapid expansion and symptomatic patients should undergo aneurysm resection regardless of size. An 87-year-old man was brought to our emergency department because of choking on food during his dinner. ⋯ Swallowing is complex neuromuscular activity consisting essentially of 3 phases: oral, pharyngeal, and esophageal. The pharyngeal phase was mainly mediated by the pharyngeal plexuses of both the glossopharyngeal and vagus nerves. Uncoordinated movement of the pharyngeal muscles because of a stretch of the left vagus nerve or its plexus by an enlarging aneurysm may be the possible mechanism of choking in this patient.

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- Shih-Yu Ko, Ken-Hing Tan, and Sun-Li Chou.
- Department of Emergency Medicine, Taipei Medical University - Shuang Ho Hospital, Zhong He City, Taipei County 235, Taiwan ROC.
- Am J Emerg Med. 2012 May 1;30(4):636.e3-4.
AbstractAortic arch aneurysm occurs more commonly in the aging population. Rapid expansion and symptomatic patients should undergo aneurysm resection regardless of size. An 87-year-old man was brought to our emergency department because of choking on food during his dinner. The patient did not have hoarseness, dysarthria, dysphagia, as well as other neurologic symptoms. He was finally found to have an aortic arch aneurysm. Swallowing is complex neuromuscular activity consisting essentially of 3 phases: oral, pharyngeal, and esophageal. The pharyngeal phase was mainly mediated by the pharyngeal plexuses of both the glossopharyngeal and vagus nerves. Uncoordinated movement of the pharyngeal muscles because of a stretch of the left vagus nerve or its plexus by an enlarging aneurysm may be the possible mechanism of choking in this patient.

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Recurrent choking as a presenting feature of aortic arch aneurysm.

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