Images in the Medical Sciences

摘要

We present a case of a 55-year-old woman with double aortic arch and separate origin of the right common carotid and right subclavian arteries. The patient had a history of dyspnea and dysphagia over 7 years, worsening over the last 2 years. Clinical examination was normal. She was treated for respiratory asthma, but her symptoms did not resolve. Electrocardiography showed normal sinus rhythm. Computed tomography showed a double aortic arch (Figure 1). The right common carotid and right subclavian arteries were originating separately from the right aortic arch, and the left common carotid and left subclavian arteries were originating from the left aortic arch (Figure 1). Computed tomography images showed no abnormal compression of trachea or esophagus by the vascular structures (Figure 2). She was offered aortic surgery but did not accept.Vascular rings are a group of congenital defects wherein the trachea and esophagus are completely encircled by vascular structures. Common symptoms of a double aorticarch with vascular ring are stridor, respiratory distress, recurrent pneumonia, dysphagia caused by tracheobronchial and/or esophageal compression.1 Congenital anomalies of the aortic arch represent less than 1% of all congenital cardiac defects.2 Case reports of elderly patients with double aortic arch or aortic ring are rare as this abnormality is usually diagnosed in childhood with symptoms related to esophageal or tracheal obstruction.