Double Aortic Arch, Double SVC, and Coronary Artery Anomaly in a 38-Year-Old Woman

Double aortic arches are rare congenital heart defects, representing <1% of congenital heart defects; most double aortic arches form a vascular ring wrapping around the trachea and esophagus. This finding typically presents in childhood with symptoms like dyspnea, stridor, and recurrent respiratory infections. Adults less commonly present with this condition; however, when they do, respiratory and gastrointestinal symptoms may be present. We present a case of a 38-year-old woman who was evaluated for dyspnea and chest pain in the emergency department, and incidentally found to have a right-dominant double aortic arch, persistent left superior vena cava, and coronary artery anomaly. The presence of these cardiac vascular anomalies is an exceptionally rare combination not previously reported together. Approaches to initial work-up and future follow-up is addressed. Awareness of these anomalies is critical because they can have major implications regarding future interventions, like catheter-based procedures and surgical planning.