Right Sided Aortic Arch Resembling Asthma.

Area of Science:

• Cardiology
• Pulmonology
• Medical Imaging

Background:

• Dyspnoea is a common asthma symptom, but persistent cases despite optimal treatment suggest infrequent causes.
• A 38-year-old patient experienced five years of refractory dyspnoea, unresponsive to standard asthma medications like salbutamol and budesonide/formoterol inhalations.

Purpose of the Study:

• To identify the underlying cause of persistent dyspnoea in a patient with a history of asthma.
• To highlight the diagnostic challenges and implications of delayed diagnosis for rare vascular anomalies causing respiratory symptoms.

Main Methods:

• Clinical case presentation of a patient with prolonged dyspnoea.
• Diagnostic workup including chest radiography and spirometry.
• Advanced imaging with contrast-enhanced computed tomography (CT) or angiography for definitive diagnosis.

Main Results:

• A right sided aortic arch was diagnosed as the cause of the patient's persistent dyspnoea.
• This rare anomaly can compress the trachea and oesophagus, mimicking respiratory conditions.
• Initial investigations like chest X-ray and spirometry showed some signs, but CT/angiography confirmed the diagnosis.

Conclusions:

• Persistent dyspnoea unresponsive to asthma therapy may indicate rare underlying conditions like a right sided aortic arch.
• Timely diagnosis through appropriate imaging is crucial to avoid prolonged ineffective treatments and unnecessary investigations.
• Identifying and treating the vascular anomaly led to symptom improvement and cessation of inappropriate asthma management.