Achalasia cardia presenting as stridor

: Achalasia cardia is a motility disorder of the oesophagus characterized by aperistalsis of the oesophageal body and incomplete relaxation of the lower oesophageal sphincter. It usually presents with dysphagia, regurgitation and heartburn. It may have various respiratory manifestations. Rarely, it may be complicated by acute airway compromise causing stridor. This case report presents an elderly woman with massive dilatation of the oesophagus secondary to achalasia, who presented with a short history of heartburn and rapid deterioration of her respiratory status due to tracheal compromise and stridor as a result of achalasia. The various hypotheses regarding the pathogenesis of this rare complication are described.