scholarly journals Asthma-like symptoms: is it always a pulmonary issue?

2018 ◽  
Vol 13 ◽  
Author(s):  
Davide Piloni ◽  
Claudio Tirelli ◽  
Rita Di Domenica ◽  
Valentina Conio ◽  
Amelia Grosso ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Aortic Arch ◽  
Pulmonary Function Tests ◽  
Vascular Ring ◽  
Final Diagnosis ◽  
Double Aortic Arch ◽  
Case Presentation ◽  
Volume Curve ◽  
Flow Volume Curve ◽  
History Of

Background: Double aortic arch is a rare congenital and complete vascular ring around trachea and esophagus. It is usually diagnosed during infancy. The symptoms are generally related to respiratory and gastroesophageal tracts. Case presentation: A 20-year-old female patient was referred to our outpatient clinic for persistent dry cough. She had a history of an episode of inhalation of food bolus as an infant and recurrent bronchitis, anorexia and allergic bronchial asthma since the childhood. Since the beginning, an intrathoracic obstruction was suspected at pulmonary function tests. After 1 month of complete asthma treatment, the cough was unchanged and the spirometry confirmed the presence of an intrathoracic obstruction. Then, she underwent a chest CT with contrast medium, a contrast transthoracic echocardiography, a fiberbronchoscopy and an esophageal radiography with contrast medium. The final diagnosis was made and a double aortic arch was found. Conclusion: A careful observation of the flow/volume curve should always be guaranteed and the presence of congenital vascular anomalies should be suspected in case of difficult-to-treat asthma.

scholarly journals Double Aortic Arch – A Case Study

2017 ◽  
Vol 10 (1) ◽  
pp. 91-93
Author(s):  
Jahan Afroze ◽  
Musavvir Samin
Keyword(s):  
Aortic Arch ◽  
Clinical Skills ◽  
Vascular Ring ◽  
Final Diagnosis ◽  
Double Aortic Arch ◽  
Middle Aged ◽  
Ct Angiogram ◽  
Middle Aged Person ◽  
Aged Person ◽  
Arch System

Double aortic arch (DAA) is one of the 2 most common forms of vascular ring, a class of congenital anomalies of the aortic arch system in which the trachea and esophagus are completely encircled by connected segments of the aortic arch and its branches. The aim of this study is to describe a case of DAA in a middle aged person. A 40 year old male came to outdoor patient department with cough and breathlessness since childhood which was diagnosed earlier as bronchial asthma, cold allergy, and dust allergy. The final diagnosis DAA was made after CT angiogram. Establishing a diagnosis of DAA in a middle aged person requires thorough understanding and clinical skills in performing steps.Cardiovasc. j. 2017; 10(1): 91-93

scholarly journals Recurrent Wheezing and Cough Caused by Double Aortic Arch, Not Asthma

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Qiao Zhang ◽  
Zhou Fu ◽  
Jihong Dai ◽  
Gang Geng ◽  
Wenlong Fu ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Lung Function Test ◽  
Double Aortic Arch ◽  
Past Medical History ◽  
Recurrent Wheezing ◽  
Vascular Abnormality ◽  
Case Presentation ◽  
Function Test ◽  
History Of ◽  
Computed Tomography Angiogram

Introduction. Double aortic arch is a congenital vascular abnormality in which the connected segments and their branches course between and compress the trachea and esophagus, often resulting in invariable airway compression. Case Presentation. A 4-year-old boy with a history of recurrent wheezing was admitted to our hospital for evaluation of asthma based on his past medical history, persistent cough, wheezing, and airway hyperresponsiveness by lung function test. Double aortic arch was diagnosed with computed tomography angiogram. After surgery, the respiratory infection improved strikingly. Early diagnosis and treatment may prevent chronic, irreversible complications. Conclusion. We present a case of double aortic arch masquerading as asthma.

Morphology of vascular ring arch anomalies influences prognosis and management

2020 ◽  
pp. archdischild-2020-319388
Author(s):  
Elena Ctori ◽  
Adrian Crucean ◽  
Benjamin Pinkey ◽  
Simon P McGuirk ◽  
Robert H Anderson ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Surgical Intervention ◽  
Longitudinal Research ◽  
Vascular Ring ◽  
Double Aortic Arch ◽  
Vascular Rings ◽  
Aortic Arch Anomaly ◽  
Mri Scans ◽  
History Of ◽  
Kommerell Diverticulum

ObjectiveThis study aimed to explore the anatomical features of aortic arch anomalies associated with vascular rings, hoping to identify those which may increase the risk of symptomatic presentation and surgical intervention.MethodsThis was a retrospective observational study at a single cardiac unit. Individuals diagnosed with an aortic arch anomaly, either isolated or non-isolated, between June 2014 and September 2018 were included. The morphology of the aortic arch was established via analysis of postnatal echocardiography, CT or MRI scans. CT and magnetic resonance studies were evaluated for the presence of a Kommerell diverticulum in those with aberrant vessels. Case notes were reviewed for relevant clinical data.ResultsOf those with aberrant subclavian arteries, 24/79 (30.4%) were shown to have a Kommerell diverticulum. Additional forms of congenital heart disease were present in 133/227 (58.6%) individuals. Surgical division of the vascular ring was performed in 30/227 (13.2%), most commonly in the setting of a double aortic arch (70.8%). In those with aberrant subclavian arteries, no children without a Kommerell diverticulum were referred for surgery. In those with a Kommerell diverticulum confirmed on imaging, 11/24 underwent surgery.ConclusionIndividuals with a double aortic arch, or an aberrant subclavian artery arising from a Kommerell diverticulum, have the highest requirement for surgical intervention, especially in isolated anomalies. These individuals should remain under monitoring. The subjective nature of symptoms remains problematic. Longitudinal research is required further to understand the natural history of vascular rings and how it links to morphology.

Double aortic arch: an elusive diagnosis in a child with CHD

2021 ◽  
pp. 1-3
Author(s):  
Mariana Lemos ◽  
Miguel Fogaça da Mata ◽  
Ana Coutinho Santos
Keyword(s):  
Ventricular Septal Defect ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Ct Angiography ◽  
Septal Defect ◽  
Vascular Ring ◽  
Pulmonary Atresia ◽  
Double Aortic Arch ◽  
Shunt Surgery

Abstract An 18-month-old male with pulmonary atresia and ventricular septal defect presented with stridor after neonatal systemic-to-pulmonary artery shunt surgery, that persisted on follow-up. CT angiography revealed a vascular ring with balanced double aortic arch.

scholarly journals Complete Vascular Ring Detected by Barium Esophagography

2002 ◽  
Vol 81 (8) ◽  
pp. 554-555 ◽  
Author(s):  
Liam J. Skinner ◽  
Stephanie Ryan ◽  
John D. Russell
Keyword(s):  
Aortic Arch ◽  
Vascular Ring ◽  
Double Aortic Arch ◽  
Vascular Rings ◽  
Barium Esophagography

The diagnosis of a vascular ring can be made on the basis of characteristic findings on barium esophagography. We report a case of a double aortic arch in a 9-month-old girl that was diagnosed in this manner, and we briefly review the anatomic characteristics of vascular rings.

DOUBLE AORTIC ARCH

PEDIATRICS ◽  
1949 ◽  
Vol 4 (6) ◽  
pp. 751-768
Author(s):  
HERBERT E. GRISWOLD ◽  
MAURICE D. YOUNG
Keyword(s):  
Aortic Arch ◽  
Double Aortic Arch ◽  
Rare Type ◽  
Radiographic Findings ◽  
Descending Aorta ◽  
Vascular Abnormalities ◽  
History Of ◽  
The Right ◽  
The Given ◽  
Right Descending Aorta

The anatomic nature of a double aortic arch is described. Reference is made to the history of the malformation. The clinical picture and radiographic findings described by various authors are discussed. Two cases are reported which demonstrate two types of double aortic arch, One, a relatively common type, had a large right arch with a retro-esophageal component and a left descending aorta; the second, a rare type, had a large left arch with a retro-esophageal component and a right descending aorta. Further, one was an infant who had symptoms of constriction whereas the other was an adult who had no symptoms referable to the double aortic arch. Analysis is made of these cases and 47 other cases reported in the literature. This analysis reveals that: 1. There is a striking correlation between the occurrence of symptoms and the age and duration of life, but there is no correlation between the occurrence of symptoms and the type of double aortic. 2. A double aortic arch in which both components are patent throughout is more likely to produce symptoms than a double aortic arch in which one component is partially obliterated. The process of obliteration does not appear to give rise to symptoms. 3. There is considerable variation in the relative sizes of the components of a double aortic arch. The right component is usually the larger; part of the left component may be obliterated. To date, no case has been reported of obliteration of part of a persistent right Component. 4. A double aortic arch occurs more commonly with a left descending aorta than with a right descending aorta. 5. It is unusual for a double aortic arch to be associated with a malformation of the heart. The association of a double aortic arch with other vascular abnormalities is less rare. The two principal problems raised by the demonstration of a retro-esophageal vessel are discussed. The first concerns the nature of the malformation; the second concerns the advisability of operation in the given individual.

scholarly journals P725 An unexpected direction: a case report of a double aortic arch in an asymptomatic woman in adulthood

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I Campos ◽  
C Vieira ◽  
N Salome ◽  
V H Pereira ◽  
A Costeira Pereira ◽  
...  
Keyword(s):  
Case Report ◽  
Aortic Arch ◽  
Ct Angiography ◽  
Vascular Ring ◽  
Double Aortic Arch ◽  
Posterior Arch ◽  
Vascular Rings ◽  
Thoracic Ct ◽  
Extrinsic Compression ◽  
The Right

Abstract Introduction Complete vascular rings represent about 0.5-2% of all congenital cardiovascular malformations, with the double aortic arch (DAA) being the most common of the complete vascular rings, causing tracheoesophageal compression. The right (posterior) arch is usually dominant (70%), although the two arches can have the same size (5%). The left (anterior) arch is dominant in only approximately 25% of cases. In most cases, this anomaly is diagnosed during childhood due to symptoms caused by oesophageal or tracheal compression. For this reason, case reports of adults are rare. This report describes a case of a 61-year-old woman with DAA with dominant left arch, diagnosed accidentallyby thoracic CT angiography. Case Report Description A 61 years old woman with a previous story of hypertension and type 1 diabetes presented to the emergency service with dyspnoea and thoracic pain. She also referred a history of intermittent dysphagia and cough with at least 12 years of progression. All the parameters of the physical examination were within normal limits. The electrocardiogram showed a normal sinus rhythm with no evidence of acute ischemia and her blood analyses did not show any abnormalitie. She also performed a thoracic CT angiography, which excluded signs of pulmonary embolism, but revealed a vascular ring suggesting a double aortic arch with permeability in both right and left arches as well as their collaterals. The Cardiac MRI was performed with the purpose of excluding ischemia, confirming the double aortic arch with left dominance. The right arch, posterior to the oesophagus and trachea, and the left arch, in an anterior position, showed an anatomic compression of the oesophagus as well as the proximal trachea, capable of eliciting the symptoms mentioned. Other congenital anomalies were excluded. The echocardiography did not demonstrate any additional cardiac malformation. Endoscopy shows a pulsatile extrinsic compression of the esophagus (aortic ring). The patient is currently being studied and closely monitored in the Cardiology consultation. Discussion The most common type of complete vascular ring is the double aortic arch, which accounts for 70% of the complete rings. In most cases, there are two permeable arches, usually with right dominance (70% of the cases). Rarely, both arches are symmetrical. Symptoms usually appear in the fifth month of life. In most cases, only supportive treatment is required. Conclusion This case illustrates the atypical features of this congenital malformation, namely the diagnosis during adulthood as well as the left dominance. Abstract P725 Figure. A double aortic arch

Anomalous origin of a pulmonary artery in a teenager with tetralogy of Fallot with associated double aortic arch and coronary arteriovenous fistula

2019 ◽  
Vol 29 (5) ◽  
pp. 727-729
Author(s):  
Vishal Agrawal ◽  
Parth Solanki ◽  
Ritesh Shah ◽  
Divyakant Parmar ◽  
Amit Mishra
Keyword(s):  
Pulmonary Artery ◽  
Aortic Arch ◽  
Tetralogy Of Fallot ◽  
Vascular Ring ◽  
Right Ventricular Outflow Tract ◽  
Left Pulmonary Artery ◽  
Ventricular Outflow Tract ◽  
Double Aortic Arch ◽  
Anomalous Origin ◽  
Tract Fistula

AbstractWe report the case of a 14-year-old female who had tetralogy of Fallot along with anomalous origin of the left pulmonary artery from the ascending aorta with co-dominant double aortic arch forming a complete vascular ring compressing the oesophagus along with a left main coronary artery to right ventricular outflow tract fistula. She underwent surgical correction without conduit placement.

scholarly journals Unilateral pulmonary vein atresia presenting with recurrent haemoptysis in a child: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Martin Ngie Liong Wong ◽  
Ing Ping Tang ◽  
Yek Kee Chor ◽  
Kiew Siong Lau ◽  
Anne Rachel John ◽  
...  
Keyword(s):  
Foreign Body ◽  
Pulmonary Vein ◽  
Cardiac Ct ◽  
Pulmonary Veins ◽  
Final Diagnosis ◽  
Foreign Body Aspiration ◽  
Case Presentation ◽  
Right Pulmonary Artery ◽  
History Of ◽  
Recurrent Haemoptysis

Abstract Background Haemoptysis is an uncommon presenting symptom in children and is usually caused by acute lower respiratory tract infection or foreign body aspiration. We report a rare case of right unilateral pulmonary vein atresia (PVA) as the underlying aetiology of recurrent haemoptysis in a child. Case presentation A 4 years old girl presented with history of recurrent haemoptysis. Bronchoscopic evaluation excluded a foreign body aspiration but revealed right bronchial mucosal hyperaemia and varices. Diagnosis of right unilateral PVA was suspected on transthoracic echocardiography which demonstrated hypoplastic right pulmonary artery and non-visualization of right pulmonary veins. Final diagnosis was confirmed on cardiac CT angiography. A conservative treatment approach was opted with consideration for pneumonectomy in future when she is older. Conclusion Rarer causes should be considered when investigating for recurrent haemoptysis in children. Bronchoscopy and cardiac imaging are useful tools to establish the diagnosis of unilateral PVA in our case.

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