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ALTE and Feeding Intolerance as a Presentation of Double Aortic Arch

Rekha Krishnasarma1, Liza Green Golan Mackintosh1, Francine Bynum1

  • 1Department of Pediatrics at the Children's Hospital of Los Angeles, Los Angeles, CA, USA.

Case Reports in Pediatrics
|October 11, 2016
PubMed

Insights

A rare case of double aortic arch caused an apparent life-threatening event (ALTE) in an infant. This congenital anomaly highlights the need for broad diagnostic considerations in infants presenting with ALTE and tracheoesophageal symptoms.

Area of Science:

  • Pediatric Medicine
  • Cardiology
  • Genetics

Background:

  • Apparent life-threatening events (ALTE) pose diagnostic challenges, especially when infants appear well upon evaluation.
  • Congenital vascular anomalies can present atypically, complicating diagnosis in pediatric patients.

Purpose of the Study:

  • To report a case of a six-month-old infant presenting with an ALTE.
  • To highlight the association between ALTE and a rare congenital anomaly, double aortic arch.
  • To emphasize the importance of a broad differential diagnosis in cases of suspected tracheoesophageal pathology.

Main Methods:

  • Case report of a six-month-old female infant.
  • Clinical evaluation for apparent life-threatening event.
  • Diagnostic workup including imaging to identify vascular and airway anatomy.

Main Results:

  • The infant presented with an apparent life-threatening event.
  • A double aortic arch, a congenital anomaly, was identified as the underlying cause.
  • The typical progressive symptoms of double aortic arch were absent in this case.

Conclusions:

  • Double aortic arch can present as an apparent life-threatening event, not solely with progressive symptoms.
  • A comprehensive differential diagnosis is crucial for infants with ALTE and clinical signs suggestive of tracheoesophageal issues.
  • Early identification of congenital anomalies like double aortic arch is vital for appropriate management.

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