Wheezing and dyspnoea caused by aberrant left innominate artery.
Masamichi HayashiKazuyoshi ImaizumiHidekazu HattoriHiroshi ToyamaMitsushi OkazawaPublished in: Respirology case reports (2017)
We present a rare case of a branching anomaly of the aortic arch that resulted in wheezing and dyspnoea. The patient was a 60-year-old male with severe wheezing from babyhood, originally diagnosed with severe bronchial asthma. On auscultation, the inspiratory and expiratory wheezes appeared when the patient leaned forward. He also had difficulty in swallowing solid mass. Tests for airway reversibility and hyperresponsiveness were negative, and asthma treatment was ineffective. He had a right aortic arch. A barium oesophagogram and endoscopic examination indicated narrowing of the oesophagus from behind. Three-dimensional reconstruction of enhanced chest CT images indicated a right aortic arch and an aberrant enlarged left innominate artery, which compressed and narrowed the oesophagus and trachea from behind. Although the patient had been diagnosed with intractable bronchial asthma, his symptoms were more likely caused by this mechanical narrowing as wheezing and dyspnoea disappeared completely after total aortic arch replacement operation.
Keyphrases
- chronic obstructive pulmonary disease
- case report
- rare case
- lung function
- allergic rhinitis
- computed tomography
- magnetic resonance imaging
- optical coherence tomography
- intensive care unit
- machine learning
- mechanical ventilation
- acute respiratory distress syndrome
- dual energy
- pet ct
- extracorporeal membrane oxygenation