Noninvasive diagnosis of right cervical aortic arch

A two-year old asymptomatic boy presented with a systolic right supraclavicular thrill. Two-D echography revealed a pulsating loop of tubular echo-free space at this site. Barium esophagogram showed a large curved retroesophageal impression. A noninvasive diagnosis of right cervical aortic arch with left descending aorta can be made on the basis of this combination of findings.