Clinical features:
(1) sudden cardiac death
(2) large food bolus impacted in the esophagus
(3) underlying esophageal disorder
(4) underlying cardiovascular disease
(5) variable minor degrees of aspiration
Possible mechanisms:
(1) tracheal compression if impaction is in proximal esophagus
(2) vagal stimulation with bradycardia or cardiac arrhythmias
(3) stress response with tachycardia and hypertension
Esophageal disorders may include:
(1) eosinophilic esophagitis
(2) gastric operation for morbid obesity
(3) stricture
(4) other cause of dysmotility
A less sudden death may be associated with esophageal perforation.
Differential diagnosis:
(1) cafe coronary (obstruction of airway by food bolus)
(2) regurgitation of food from the stomach into the esophagus at death
