Incidental diagnosis of co-dominant double aortic arch in an adult: A rare cause of chronic cough and chest pain

Abstract

Double aortic arch (DAA) is a rare congenital vascular anomaly forming a complete vascular ring that may compress the trachea and esophagus. While commonly presenting in infancy, adult cases are uncommon and often incidentally diagnosed. This report describes a 39-year-old female with chronic cough and chest pain. Initial echocardiography suggested abnormal aortic anatomy, leading to further evaluation with ECG-gated triple rule-out CT angiography. Imaging revealed a co-dominant DAA with absence of the right brachiocephalic artery and esophageal compression, without aneurysm or stenosis. The patient’s symptoms were attributed to the vascular ring, managed conservatively due to the absence of severe complications. This case underscores the importance of considering congenital vascular rings in adults with unexplained respiratory or esophageal symptoms. Advanced imaging is crucial for accurate diagnosis and management. Increased awareness of these anomalies can improve clinical outcomes.