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

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.