Document Detail

Stridor in a 6-week-old infant caused by right aortic arch with aberrant left subclavian artery.
MedLine Citation:
PMID:  10395419     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Persistent infant stridor, seal-like cough, and difficulty feeding can be the initial signs of right aortic arch with an aberrant left subclavian artery. This congenital cardiovascular abnormality results in the development of a vascular ring that encircles the trachea and esophagus. METHODS: A case report is presented that describes the evaluation and care of a 6-week-old male infant whose condition was diagnosed as right aortic arch and aberrant left subclavian artery after he was brought to the family practice clinic with a history of persistent stridor. This case report involved a patient seen in the author's outpatient clinic during a well-child check. Data were obtained from the patient's medical record and review of his radiologic diagnostic tests. MEDLINE and Index Medicus literature searches were conducted for the years 1966 to the present, using the key words "stridor" and "vascular ring," with cross-references for earlier articles. RESULTS AND CONCLUSIONS: Persistent or recurrent stridor associated with feeding difficulties should prompt an investigation for a vascular ring. In general, an anteroposterior and lateral neck radiograph and a posteroanterior and lateral chest radiograph are usually the initial diagnostic tests to evaluate stridor. Persistent stridor and new-onset regurgitation of formula in a 6-week-old infant prompted an escalation of the patient's workup to include a barium swallow, which subsequently showed compression of the esophagus caused by a vascular ring. In some cases direct observation with a laryngoscope or bronchoscope might be necessary to determine the cause of stridor. Indications for hospitalization of patients with stridor include stridor at rest, dyspnea, actual or suspected epiglottis, repeatedly awakening from sleep with stridor, a history of rapid progression of symptoms, toxic appearance, and apneic or cyanotic episodes. The primary care provider should be familiar with the evaluation and management for patients with the complaint of persistent or recurrent stridor.
L McDougle
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of the American Board of Family Practice / American Board of Family Practice     Volume:  12     ISSN:  0893-8652     ISO Abbreviation:  J Am Board Fam Pract     Publication Date:    1999 May-Jun
Date Detail:
Created Date:  1999-08-13     Completed Date:  1999-08-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8807505     Medline TA:  J Am Board Fam Pract     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  219-24     Citation Subset:  IM    
Department of Family Medicine, University of Michigan, Ypsilanti 48198, USA.
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MeSH Terms
Aorta, Thoracic / abnormalities*
Esophageal Stenosis / etiology
Respiratory Sounds*
Subclavian Artery / abnormalities*
Tracheal Stenosis / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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