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Persistent fifth aortic arch (PFAA) can present uniquely. This case highlights PFAA with severe left ventricular dysfunction, suggesting it as a differential diagnosis for infant heart issues.

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Area of Science:

  • Cardiovascular Medicine
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Persistent fifth aortic arch (PFAA) typically presents with mild or severe symptoms.
  • Previous reports describe PFAA patients with upper body hypertension or neonatal ductal shock.

Observation:

  • This case presents a unique clinical course of PFAA with mild distal narrowing and an interrupted fourth aortic arch.
  • The patient exhibited severe left ventricular (LV) dysfunction, indicating sustained aortic narrowing and poor collateral circulation.

Findings:

  • The patient's condition was classified as medium severity based on hospital presentation timing.
  • Severe LV dysfunction in this PFAA case suggests significant hemodynamic compromise.

Implications:

  • This case expands the spectrum of PFAA presentations.
  • Severe LV dysfunction associated with PFAA warrants consideration as a differential diagnosis in infants.
  • Highlights the importance of considering congenital aortic anomalies in infantile heart failure.