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Asthma-like symptoms: is it always a pulmonary issue?
Davide Piloni1,2, Claudio Tirelli3, Rita Di Domenica1
11Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
Multidisciplinary Respiratory Medicine
|August 21, 2018
Summary
Double aortic arch, a rare congenital vascular ring, can present in adulthood with persistent cough. Suspecting this anomaly is crucial for diagnosing difficult-to-treat asthma.
Area of Science:
- Cardiology
- Thoracic Surgery
- Pediatric Surgery
Background:
- Double aortic arch is a rare congenital vascular anomaly forming a complete ring around the trachea and esophagus.
- Typically diagnosed in infancy, symptoms often involve respiratory and gastroesophageal issues.
Observation:
- A 20-year-old female presented with persistent dry cough, a history of childhood recurrent bronchitis, anorexia, and allergic asthma.
- Pulmonary function tests initially suggested an intrathoracic obstruction, which persisted despite asthma treatment.
Findings:
- Diagnostic imaging, including chest CT, echocardiography, fiberbronchoscopy, and esophageal radiography, confirmed a double aortic arch.
- The patient's persistent respiratory symptoms were attributed to this congenital vascular anomaly.
Implications:
- This case highlights that double aortic arch can manifest in adulthood with atypical respiratory symptoms.
- Congenital vascular anomalies should be considered in cases of refractory asthma or persistent cough, especially when flow/volume curves indicate obstruction.
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