Dyspnea in Patient with Arteria Lusoria: A Case Report

Abstract

Introduction: Arteria lusoria is an aberrant right subclavian artery. In symptomatic cases, patients report dysphagia and only in few cases dyspnea, due to external compression of the trachea and esophagus. Symptoms occur in advanced age and diagnosis is made with chest HRCT, when other causes of dysphagia have been excluded.

Case report: An 83-year-old woman presented with dyspnea and mechanical dysphagia for solids. Therefore, she did a chest high-resolution computed tomography (HRCT) that showed areas of consolidation of the lung parenchyma, pleural effusion and presence of arteria lusoria, with a retroesophageal course. After 18 days, dysphagia and dyspnea worsened. The new chest HRCT revealed bilateral atelectasis of the lower lung lobes and severe compression of esophagus and trachea along the course of the arteria lusoria.

Conclusion: Considering its dangerousness, this vascular anomaly should be considered in advanced aged patients with dysphagia and dyspnea, once other causes have been excluded.

Keywords: Arteria lusoria; Dysphagia; Dyspnea; Vascular anomaly.

Fig 1

HRTC, axial section (T=trachea, E= esophagus, AL = arteria lusoria)

Fig 2

HRCT, sagittal section (T= trachea, E= esophagus, AL = arteria lusoria)

Fig 3

HRTC, axial section (T= trachea, E= esophagus, AL = arteria lusoria)

Fig 4

HRCT, sagittal section (T = trachea, E = esophagus, AL = arteria lusoria)

Fig 5

HRCT, axial section (T = trachea, E = esophagus, AL = arteria lusoria)

Fig 6

HRCT, sagittal section (T = trachea, E = esophagus, AL = arteria lusoria)