RT Journal Article
SR Electronic
T1 Image of the month: An unusual cause of cough, stridor and dyspnoea: A giant aortic arch aneurysm
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP e313
OP e314
DO 10.7861/clinmed.2021-0095
VO 21
IS 3
A1 Bhupinder Singh
A1 Abhishek Goyal
A1 Shibba T Chhabra
A1 Naved Aslam
A1 Bishav Mohan
A1 Gurpreet S Wander
YR 2021
UL http://www.rcpjournals.org/content/21/3/e313.abstract
AB A 78-year-old man with hypertension presented with dry cough and gradually progressive dyspnoea for 3 months. The patient had an audible stridor. Cardiovascular examination was unremarkable. Respiratory system examination revealed both inspiratory and expiratory grunting sound. Laboratory investigations were normal. Electrocardiography showed sinus rhythm with left ventricular hypertrophy (LVH). Chest X-ray showed superior mediastinal widening. Transthoracic echocardiography showed preserved LV functions and dilated aortic arch. Contrast-enhanced computed tomography of the thorax showed a huge aortic arch aneurysm compressing the adjacent trachea. The patient was planned for hybrid aortic arch repair but the patient refused and was discharged on antihypertensive, antiplatelet and statin therapy. The patient continued to have limiting cough, dyspnoea and stridor for 4 months of follow-up until he suddenly died while at home. This case highlights an unusual presentation of a potentially lethal disease. Evaluation of patients presenting with cough and dyspnoea should not be restricted to respiratory diseases. The critical observations made from history