Cough from megaoesophagus.

Mrs FW, 83 years of age, presented to the emergency department with repeated episodes of attacks of vomiting over several months, coughing, weight loss and worsening shortness of breath. On examination she was not distressed, but mildly dehydrated. Chest examination revealed decreased air entry in both sides of the chest. Heart sounds were muffled. Other examination was within normal limits.