Double aortic arch: An uncommon diagnosis presenting with recurrent respiratory symptoms.

Abstract

A vascular ring is defined as an anomaly of the great arteries (aortic arch and its branches) that
 compresses the trachea and/or oesophagus. Double aortic arch is one of the most common types of vascular
 rings.
 We present a male newborn infant with double aortic arch who initially presented with inspiratory stridor
 since birth that was aggravated by crying. He was initially worked up as a case of congenital laryngomalacia.
 At 26 days of age, he presented to the emergency department with attacks of cough associated with stridor,
 interrupted breastfeeding, irritability, cyanosis and apnoea. Investigations were done and the diagnosis
 of double aortic arch was made by echocardiography and confirmed by contrast-enhanced computed
 tomography.
 Standard surgical division of ligamentum arteriosum was able to relieve the trachea and the symptoms