ABSTRACT
Extrinsic esophageal compression leading to dysphagia is a recognized but uncommon presentation of thoracic aortic aneurysms. This has been referred to as dysphagia aortica, and is a late presentation of large thoracic aneurysms. We present the case of a young man of age 31 years, who was referred to us for cardiological evaluation for on and off chest pain and backache with dysphagia and abnormal chest X-ray showing dilated descending aorta. Eventually, thoracic-abdominal aortic aneurysm causing compression of the esophagus was discovered. When dealing with patients who present with dysphagia and on and off chest pain and backache if no other cause is discovered, a thoracic aortic aneurysm should form part of the differential diagnosis, as this is potentially curable, and delay in diagnosis and treatment predisposes to rupture and death.