Cardiovascular dysphagia is that which is due to luminal obstruction from extrinsic cardiovascular compression of the esophagus (anomalous left subclavian artery, double aortic arch, right aortic arch, cervical aortic arch, Kommerell’s diverticulum, ligamentum arteriosum, aortic aneurysm or dissection, aorto-oesophageal fistula, post-cardiovascular and left atrial dilatation). The diagnosis is frequently suggested by radiographic findings as a barium swallow, and supported by endoscopic and echocardiographic findings. This article presents a 73-year-old woman with progressive dysphagia and enlarged left atrium secondary to mitral valvulopathy and rheumatic fever.