Cerebral Embolization Resulting From Esophageal-Atrial Fistula

L. J. Michael Mott, MD; Garth E. Austin, MD, PhD
Arch Intern Med. 1976;136(6):718-720. doi:10.1001/archinte.1976.03630060070014.
Text Size: A A A
Published online

While nontraumatic esophageal perforation, so-called Boerhaave syndrome, is a well-established entity, it only rarely results in a fistulous communication between the esophagus and the heart, great vessels, or pericardium. We report one such unusual lesion, an esophagealleft atrial fistula. A symptom complex, based on comparisons with previous cases, is described. With this information, future cases may be recognized in time for therapeutic intervention.

PATIENT SUMMARY  A 51-year-old housewife was being followed up for systemic lupus erythematosus of five-years' duration that was manifested by moderate proteinuria and hypertension. She had iatrogenic Cushing syndrome, secondary to prednisone therapy. In addition, she had a 20-year history of hiatus hernia with esophageal reflux and erosive esophagitis that was repeatedly demonstrated radiologically and by esophagoscopy. On antacid therapy, the patient experienced moderate dysphagia and suffered episodes of mild hematemesis once or twice a year. In 1968, examination revealed a distal esophageal stricture, and the patient


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.