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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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The coronary arteries, originating from the ascending aorta, bifurcate from two sinuses located within the ascending aorta. Positioned just above the aortic semilunar valve, these sinuses house essential aortic baroreceptors and chemoreceptors, crucial for maintaining cardiac function. The left coronary artery and the right coronary artery branch off from the left posterior and anterior aortic sinuses, respectively.
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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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The thoracic section of the aorta begins at the T5 vertebra and extends to the T12 level at the diaphragm, initially progressing through the mediastinum to the left of the spinal column. Throughout its course in the thoracic segment, the thoracic aorta emits various offshoots known collectively as visceral and parietal branches. The branches that predominantly supply blood to visceral organs are termed visceral branches and include bronchial, pericardial, esophageal, and mediastinal arteries,...
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The aorta is the largest artery in the human body. It originates from the left ventricle of the heart and extends down to the abdomen, where it splits into two smaller arteries. Structurally, it can be divided into four main parts: the ascending aorta, the aortic arch, the thoracic aorta, and the abdominal aorta.
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Double Aortic Arch in an Asymptomatic Adult.

William J Lee1, Yash K Shah1, Albert Ku2

  • 1Radiology, Rutgers University, Newark, USA.

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|May 14, 2023
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Summary

A rare double aortic arch (DAA) was incidentally found in a 60-year-old man. This vascular anomaly, usually seen in children, can present in adults due to factors like reduced vascular compliance.

Keywords:
adult maledouble aortic archesophageal compressionincidental radiological findingtracheal compressionvascular ring

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Area of Science:

  • Cardiovascular Medicine
  • Radiology
  • Congenital Heart Disease

Background:

  • Double aortic arch (DAA) is a rare congenital vascular anomaly forming a complete vascular ring.
  • It typically presents in infancy or childhood with symptoms of esophageal or tracheal compression, such as dysphagia or dyspnea.
  • Adult diagnosis is uncommon and often linked to the delayed onset of obstructive symptoms.

Observation:

  • A 60-year-old male presented with pneumonia, and a computed tomography (CT) scan incidentally revealed a double aortic arch.
  • The patient exhibited no symptoms of dysphagia or dyspnea, which are common in pediatric DAA cases.
  • This case highlights an asymptomatic presentation of DAA in an adult.

Findings:

  • The incidental finding of DAA in an adult without typical obstructive symptoms is rare.
  • Factors contributing to late presentation include the absence of associated congenital anomalies, minimal childhood compression, and reduced vascular compliance in adulthood.
  • CT imaging is crucial for identifying such vascular anomalies incidentally.

Implications:

  • This case broadens the understanding of DAA presentation, emphasizing its potential for asymptomatic occurrence in adults.
  • It underscores the importance of recognizing DAA in adult imaging, even when symptoms are absent.
  • Further research into the natural history and management of incidentally discovered adult DAA is warranted.