Key result
Thoracic CT identifies symptomatic incomplete double aortic arch missed by echocardiography and chest X-ray.
Why the study?
Double aortic arch is a rare, potentially life-threatening congenital condition that may present with respiratory and digestive symptoms due to extrinsic tracheal and esophageal compression.
Case Report (n=1)
No
This case report highlights that an incomplete double aortic arch causing tracheal compression in a pediatric patient may be missed on transthoracic echocardiography and requires thoracic computed tomography for definitive diagnosis.
Answers are grounded in this paper and cite their sources.
May warrant thoracic CT for unexplained toddler respiratory distress after normal X-ray and echo; leaves open vascular ring variant prevalence.
Summary Double aortic arch (DAA) is a rare congenital condition that can be life-threatening. It is discovered incidentally during radiological examination or due to respiratory and digestive symptoms caused by extrinsic airway compression by a vascular ring that squeezes the trachea and esophagus. Herein, we describe a case of a 24-month-old toddler who presented with stridor-like dyspnea and a productive cough in an apyretic context, for which he was hospitalized several times. At admission, physical examination revealed a patient with failure to thrive and diffuse bronchial rales on auscultation. Chest X-ray showed no aortic button alongside normal pulmonary parenchyma. Transthoracic echocardiography also appeared normal. However, a complementary thoracic computed tomography (CT) scan revealed an incomplete DAA anomaly causing an incomplete vascular ring compressing the trachea.
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Boukheloua et al. (2026) conducted a case report in Double aortic arch (DAA) malformation with acute respiratory distress (n=1). Thoracic computed tomography (CT) scan vs. Chest X-ray and transthoracic echocardiography was evaluated on Diagnosis of incomplete double aortic arch causing tracheal compression. Thoracic CT identified an incomplete double aortic arch compressing the trachea in a 24-month-old boy after chest X-ray and echocardiography appeared normal.
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