Vascular ring diagnosis following respiratory arrest

Area of Science:

• Pediatric Cardiology
• Thoracic Surgery
• Medical Imaging

Background:

• Vascular rings, congenital anomalies of the aortic arch, can cause varied symptoms.
• Early diagnosis of vascular rings is crucial but often challenging due to non-specific presentations.

Observation:

• A previously healthy 14-month-old infant presented with acute respiratory arrest secondary to esophageal food bolus impaction.
• The infant had a history of recurrent wheeze and noisy breathing, suggestive of an underlying airway issue.

Findings:

• Esophagoscopy and bronchoscopy indicated a vascular ring anomaly.
• Contrast-enhanced CT confirmed a right-sided aortic arch with a left ligamentum arteriosum compressing the esophagus and airway.
• Surgical ligation and division of the ligament were performed.

Implications:

• This case highlights an uncommon acute presentation of a vascular ring anomaly.
• Prompt diagnosis and surgical intervention are vital for managing vascular ring complications.
• Early recognition of subtle respiratory and esophageal symptoms can prevent critical events.