Adult-onset dysphagia lusoria secondary to a dissecting aberrant right subclavian artery associated with type B acute aortic dissection

Retro-oesophageal right subclavian artery in association with thyroid ima artery: a case report, clinical impact and review of the literature

“…Natsis et al [49] highlighted that the coexistence of arteria lusoria and BCT appears in up to 2.78% in Caucasians. Moreover, higher incidence of arteria lusoria has been reported in patients with Down syndrome (12-37%) [16,29,57,74], Edwards and DiGeorge syndrome and congenital heart disease [45,63]. The artery may also coexist with long gap oesophageal atresia and trachea-oesophageal fistula in neonates [13].…”

“…Persistent cough may be the main symptom due to the pulsatile action of the aberrant artery on the tracheal wall [57] or the compression exerted by an existing aneurysm on the adjacent structures. Dyspnoea, stridor, feeding difficulty, recurrent respiratory infections are the main symptoms in childhood, due to the vulnerable trachea, while dysphagia is the primary symptom in adults [27,53,59,63]. Clinicians should not forget that in paediatric population, serious respiratory discomfort may appear without dysphagia [36].…”

Cardiovascular dysphagia — anatomical and clinical implications

“…Patients with dissection of ascending aorta (with intramural haematoma), aortic arch, descending aorta or an ARSA may manifest mild, intermittent [95], or progressive dysphagia [14], with occasional hoarseness [66]. Occasional dysphagia [21], mild dysphagia (right-sided aorta with Kommerell's diverticulum) [24] and weight loss can be associated symptoms to dysphagia in elderly thoracic aortic aneurysm patients [27,29].…”

“…a giant saccular pseudoaneurysm can also compress the distal oesophagus and the left atrium [57]. Transoesophageal echocardiography, computed tomography, magnetic resonance imaging [14], videofluoroscopic swallowing study [66], and oesophagogram [95] may reveal the nature of oesophageal compressions. Immediate aortic surgery [14] or stent graft insertion with total exclusion and shrinkage of the aneurysm may relieve the patient's symptom [82].…”

Acute dysphagia associated with aortic dissection: a case report and review of the literature

“…It is the most common acute disease of the aorta and usually presents with acute chest or back pain [1]. Intrathoracic aortic dissection may cause various neurologic deficits, progressive dysphagia, and neck pain without any apparent chest symptoms [2][3][4].…”