Tracheobronchial Compression by Right-sided Aortic Arch in a Middle Aged Male
Manohar Lal Gupta, Chand Bhandari, Jyotsna Sinha
Keywords :
Tracheomalacia, Exertional dyspnoea, Variable intrathoracic airway obstruction, Right side aortic arch
Citation Information :
Gupta ML, Bhandari C, Sinha J. Tracheobronchial Compression by Right-sided Aortic Arch in a Middle Aged Male. Indian J Chest Dis Allied Sci 2012; 54 (1):45-47.
Exertional dyspnoea is a common symptom among middle-aged population. Diagnostic evaluation of such patients is often challenging and confusing. We report a patient presenting with exertional dyspnoea and an obstructive ventilatory defect on spirometry that was refractory to bronchodilator therapy. Careful review of the chest radiograph and spirometry pointed towards variable intra-thoracic airways obstruction as a cause of dyspnoea. Contrast enhanced computed tomography (CECT) of the thorax and bronchoscopy established the diagnosis of a right-sided aortic arch resulting in tracheobronchial compression and tracheomalacia.
Bakker DA, Berger RM, Witsenburg M, Bogers AJ. Vascular rings: a rare cause of common respiratory symptoms. Acta Paediatr 1999;88:947-52.
Stewart JR, Kincaid OW, Titus Jl. Right aortic arch: plain film diagnosis and significance. Am J Roentgenol Radium Ther Nucl Med 1966;97:377-89.
Greiner A, Perkmann R, Rieger M, Neuhauser B, Fraedrich G. Vascular ring causing tracheal compression in an adult patient. Ann Thorac Surg 2003;75:1959-60.
Winn RA, Chan ED, Langmack EL, Kotaru C, Aronsen C. Dysphagia, chest pain and refractory asthma in a 42- year-old woman. Chest 2004;126:1694-7.
Ko Y-K, Hsiao C-L, Lee Y-J. Right aortic arch with a complete vascular ring causing tracheoesophageal compression. J Intern Med Taiwan 2007;18:104-7.
Gross RE, Neuhauser EB. Compression of the trachea by an anomalous innominate artery: an operation for its relief. Am J Dis Child 1948;75:570-4.
Edwards JR. Congenital cardiovascular causes of tracheobronchial and/or esophageal obstruction. In: Tucker BL, Lindesmith GG, eds First Clinical Conference on Congenital Heart Disease. New York: Grune and Stratton; 1979: p. 49-95.
Gidding SS, Beekman RH, Lebowitz E, Wesley J, Coran A, Behrendt D, et al. Airways compression by a right aortic arch in the absence of a vascular ring. Chest 1984;85:703- 5.
