Achalasia is characterized by primary motility disorder of esophageal body and lower esophageal sphincter (LES) involving absence of progressive peristalsis in the esophageal body and abnormal relaxations of the LES. Dilated esophagus may be compressing the surrounding tissue after achalasia. Exposure to external compression of the left atrium is not a common condition. Clinical conditions can vary according to the shape of the press. Seventy-six year-old female patient was admitted to our clinic with complaints of shortness of breath and fatigue. The patient’s dyspnea began six months ago and increased for the last 2 weeks. On physical examination, blood pressure 110/65 mm/Hg, the heart beats 84 beats/min, rhythmic. Two dimensional transthoracic echocardiography showed an echolucent mass, which was later confirmed to be achalasia by computed tomography, compressing the left atrium. Patient’s ejection fraction (EF) %60, left atrial dimension was 3,6 cm. Patient consulted by gastroenterology and general surgery and surgery was planned. It must always be kept in mind that dorsal structures to the left atrium should have paramount attention when evaluating the patients who complain dyspnea.
