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Images in Cardiology |

Double Aortic Arch Presents With Dysphagia as Initial Symptom

Monica Fernandez-Valls, MD; Javier Arnaiz, MD; Dickson Lui, MD; Maria Elena Arnaiz-Garcia, MD; Ana Canga, MD; Rafael Martin-Duran, PhD
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Copyright 2012, American College of Cardiology Foundation. All Rights Reserved.

J Am Coll Cardiol. 2012;60(12):1114-1114. doi:10.1016/j.jacc.2012.02.084
Published online
Figures in this Article

A 62-year-old woman presented with breathlessness and dysphagia. Routine chest x-ray showed a widening in the upper mediastinum that suggested a thoracic aorta enlargement. No cardiomegaly was found (A). Transthoracic echocardiography revealed normal left ventricular systolic function with diastolic dysfunction and aortic sclerosis. Magnetic resonance angiography demonstrated a double aortic arch forming a vascular ring, thus compressing the esophagus (B to D). This is a rare congenital cardiovascular disorder (1%), usually diagnosed at an early age. It is possible to reach middle to late adulthood with this pathology, as shown by this patient, and it can produce severe symptoms by compressing the trachea and esophagus. AA = ascending aorta; E = esophagus; LCCA = left common carotid artery; LSA = left subclavian artery; PA = pulmonary artery; RCCA = right common carotid artery; RSA = right subclavian artery; T = trachea.

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