Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Aug 3:13:21.
doi: 10.1186/s40248-018-0136-5. eCollection 2018.

Asthma-like symptoms: is it always a pulmonary issue?

Davide Piloni  1   2 , Claudio Tirelli  3 , Rita Di Domenica  1 , Valentina Conio  1 , Amelia Grosso  1 , Vanessa Ronzoni  1 , Filippo Antonacci  4 , Pasquale Totaro  4 , Angelo G Corsico  1   3
Affiliations
Case Reports

Asthma-like symptoms: is it always a pulmonary issue?

Davide Piloni et al. Multidiscip Respir Med. .

Abstract

Background: Double aortic arch is a rare congenital and complete vascular ring around trachea and esophagus. It is usually diagnosed during infancy. The symptoms are generally related to respiratory and gastroesophageal tracts.

Case presentation: A 20-year-old female patient was referred to our outpatient clinic for persistent dry cough. She had a history of an episode of inhalation of food bolus as an infant and recurrent bronchitis, anorexia and allergic bronchial asthma since the childhood. Since the beginning, an intrathoracic obstruction was suspected at pulmonary function tests. After 1 month of complete asthma treatment, the cough was unchanged and the spirometry confirmed the presence of an intrathoracic obstruction. Then, she underwent a chest CT with contrast medium, a contrast transthoracic echocardiography, a fiberbronchoscopy and an esophageal radiography with contrast medium. The final diagnosis was made and a double aortic arch was found.

Conclusion: A careful observation of the flow/volume curve should always be guaranteed and the presence of congenital vascular anomalies should be suspected in case of difficult-to-treat asthma.

Keywords: Central airway; Double aortic arch; Persistent cough; Spirometry.

PubMed Disclaimer

Conflict of interest statement

Not applicable. Written signed informed consent for publication of this Case report was obtained from the patient and a copy of the consent form is available for review by the Editor of this Journal. The authors declare that they have no competing interests. AGC is Associate Editor of Multidisciplinary Respiratory Medicine. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a flow/volume curve at the first pulmonary function test; b flow/volume curve after 1 month of therapy
Fig. 2
Fig. 2
a CT scan with contrast medium highlighting the presence of a complete Double Aortic Arch (axial and sagittal reconstructions). Red circles indicate the 2 arches surrounding the trachea and esophagus. b Arterial phase CT: 3D reconstructions of the aorta, showing the DAA
See this image and copyright information in PMC

References

    1. Kliegman RM, Stanton B, Geme J, Schor NF, Behrman RE. Annals of Internal Medicine. Philadelphia: Elsevier; 2011.
    1. Calabrese C, Corcione N, Di Spirito V, Guarino C, Rossi G, Domenico Gargiulo G, et al. Recurrent respiratory infections caused by a double aortic arch: the diagnostic role of spirometry. Respir Med Case Rep. 2013;8(1):47–50. - PMC - PubMed
    1. Gross RE. Arterial malformations which cause compression of the trachea or esophagus. Circulation. 1955;11(1):124–134. doi: 10.1161/01.CIR.11.1.124. - DOI - PubMed
    1. Uchida DA. Late presentation of double aortic arch in school-age children presumed to have asthma: the benefits of spirometry and examination of the flow-volume curve. Respir Care. 2009;54(10):1402–1404. - PubMed
    1. Lima JA, Rosenblum BN, Reilly JS, Pennington DG, Nouri-Moghaddam S. Airway obstruction in aortic arch anomalies. Otolaryngol Head Neck Surg. 1983;91(6):605–609. doi: 10.1177/019459988309100603. - DOI - PubMed

Publication types