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[Chronic wheezing child and type "D" double aortic arch: case report]

Raúl E Ríos-Méndez1, María E Aráuz-Martínez

  • 1Sección de Cardiología pediátrica, Sanatorio Güemes. riosmendez@intramed.net.ar

Archivos Argentinos De Pediatria
|December 25, 2008
PubMed

Insights

A rare vascular ring, right aortic arch with retroesophageal left innominate artery and patent ductus arteriosus, can mimic asthma in children. This case highlights the importance of considering vascular anomalies in non-responsive respiratory symptoms.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Thoracic Surgery

Background:

  • Vascular rings are congenital anomalies of the aortic arch.
  • Right aortic arch with retroesophageal left innominate artery and patent ductus arteriosus forms a complete vascular ring (Type D double aortic arch).
  • Symptoms like dysphagia, stridor, and wheezing are common in infants but less frequently diagnosed in older children.

Observation:

  • An 8-year-old patient presented with symptoms suggestive of asthma unresponsive to treatment.
  • Diagnostic workup confirmed a rare vascular ring anomaly: right aortic arch with retroesophageal left innominate artery and patent ductus arteriosus.
  • This diagnosis was considered due to the patient's age and atypical presentation.

Findings:

  • The vascular ring was identified as the underlying cause of the patient's persistent respiratory symptoms.
  • The case demonstrates that vascular rings can present atypically in older children, mimicking other conditions.
  • This specific type of vascular ring is uncommon.

Implications:

  • Highlights the need to consider vascular ring anomalies in the differential diagnosis of pediatric respiratory conditions, especially when unresponsive to standard treatments.
  • Suggests that delayed diagnosis of vascular rings in older children may occur due to atypical presentations.
  • Emphasizes the importance of comprehensive diagnostic evaluation for persistent respiratory symptoms in children.

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