![]() The cardiovascular findings were unremarkable. Respiratory sounds were coarse and inspiratory stridor and bilateral diffuse rhonchi were appreciated. The chest X-ray revealed hyperinflated lung fields bilaterally. His respiratory rate was 50 breaths/min SpO 2 was 95% at room air. At presentation the patient was in moderate distress with suprasternal, subcostal and intercostal retractions. Mom reports that noisy breathing improved slightly, but it did not change with position, alertness or feeding status. He was evaluated by ENT because of inspiratory stridor at 2 months of age and the laryngoscopic evaluation was reported as normal. In his past medical history: the baby was noted to have noisy breathing at 2 nd-3 rd weeks of his life. The patient was transferred to our hospital for further evaluation and treatment after 7 days of intensive inhaler therapy, antibiotic and anti-reflux treatments. Since respiratory distress was persistent and his complaints worsened with feeding, antibiotic and anti-reflux therapy were added to the treatment with the pre-diagnosis of aspiration pneumonia. The patient was started on prednisolone and inhaler therapy. According to the patient's medical records, the patient initially was admitted with the complaints of difficulty in breathing, wheezing and cough with the diagnosis of acute bronchiolitis. Ī 4-month-old full term male infant was transferred from another medical center for the management of respiratory distress. Diagnosis may be difficult because of the variations in the clinical spectrum. Abnormal regression of the brachial arch during embryogenesis results in persistence of two aortic arches, forming a vascular ring and compressing the trachea and/or esophagus. ![]() Double aortic arch is the most common anomaly among vascular ring pathologies (40%). ![]() Vascular ring is seen with an incidence of 1% in all congenital cardiovascular anomalies. Respiratory distress, Vascular ring, Infant A case of double aortic arch presented with respiratory distress, stridor, and feeding intolerance during infancy is discussed. Double aortic arch is the most common vascular ring anomaly. Vascular ring, which is a rare cause of respiratory distress in infants, results in respiratory and gastrointestinal findings due to tracheal and/or esophageal compression, but the diagnosis may be delayed because of the nonspecific symptoms.
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