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Aortic arch anomaly presenting as exercise-induced asthma.

F Bevelaqua¹, J S Schicchi, F Haas

¹Pulmonary Function Laboratory, New York University Medical Center, New York.

The American Review of Respiratory Disease

|September 1, 1989

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A rare right aortic arch caused severe tracheal narrowing in a young woman, mimicking exercise-induced bronchospasm. This vascular anomaly led to significant airway obstruction, highlighted by flow-volume loops and confirmed by MRI.

Area of Science:

Cardiology
Pulmonology
Medical Imaging

Background:

A right aortic arch is a congenital anomaly where the aorta arises from the left ventricle and arches over the right main bronchus.
Symptoms associated with congenital vascular anomalies can be diverse and may manifest later in life, often triggered by specific physiological stresses.

Observation:

A young woman presented with symptoms suggestive of exercise-induced bronchospasm during vigorous physical activity.
Pulmonary function tests, specifically flow-volume curves, revealed variable intrathoracic large airways obstruction.
Magnetic resonance imaging (MRI) was utilized to investigate the cause of the observed airway obstruction.

Findings:

The MRI confirmed severe tracheal narrowing.
The tracheal narrowing was directly attributed to the anatomical positioning of a right aortic arch.

Related Experiment Videos

This case highlights a rare presentation of a congenital vascular anomaly causing significant respiratory compromise.

Implications:

Congenital aortic arch anomalies should be considered in the differential diagnosis of unexplained exercise-induced respiratory symptoms, even in young adults.
Advanced imaging techniques like MRI are crucial for diagnosing complex vascular-related airway obstructions.
Understanding the interplay between congenital cardiovascular anomalies and respiratory mechanics is vital for effective patient management.