Kadwani, O, Price, OJ, Kemp, SV et al. (2 more authors) (2020) A vascular cause of unexplained exertional wheeze: Keeping a high index of suspicion. Respiratory Medicine Case Reports, 29. 100993. ISSN 2213-0071
Abstract
A 31-year-old female was referred with a history of unexplained exertional breathlessness. The patient had normal resting lung function and a CT thorax showed no significant abnormality. Closer scrutiny of the flow-volume loop confirmed an elevated Empey's index. Cardiopulmonary exercise testing with continuous laryngoscopy was conducted to evaluate the upper airway response to exercise which confirmed loud biphasic wheeze. A bronchoscopy revealed no stenosis nor intraluminal narrowing, however, a contrast CT confirmed a right-sided aortic arch and aberrant left subclavian artery. Following multidisciplinary review, the patient opted for a surgical approach to treatment however despite initially reporting an improvement in symptoms and exercise capacity continued to suffer exertional wheeze two-years post-surgery. This clinical report describes a rare vascular cause of exertional wheeze but also provides a cautionary note in terms of providing a guarded prognosis for adults undergoing surgical intervention for tracheal compression arising from congenital vascular abnormalities.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Dyspnoea; Cough; Wheeze; Bronchoscopy |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Biological Sciences (Leeds) > School of Biomedical Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 30 Jun 2021 10:43 |
Last Modified: | 30 Jun 2021 10:43 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.rmcr.2019.100993 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:175680 |