A 55-year-old male was referred by his general practitioner due to mild complaints of shortness of breath (no angina) upon exertion. He used to work as a gym teacher at a secondary school and currently exercises intensively for up to 10 h a week. His father died suddenly at the age of 52 years while cross-country skiing. No autopsy was performed. The patient is being treated with perindopril 2 mg once a day due to hypertension and has a blood pressure of 140/90 mm Hg and a resting peripheral O2 saturation of 97% when breathing room air. Electrocardiography showed sinus rhythm with normal de- and repolarisation and a physical examination did not reveal any abnormalities. Transthoracic echocardiography showed normal biventricular and valvular function. Chest radiography revealed an abnormality and prompted further investigation by computed tomography (Fig. 1a–c).
Fig. 1
An anteroposterior chest radiograph (a) and the corresponding frontal plane (b) and transverse plane (c) CT images of the patient described
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What is the most likely diagnosis?
A.
Acute aortic syndrome
B.
Persistent left superior vena cava
C.
Right-sided aortic arch with an aberrant left subclavian artery
D.
Double aortic arch
Answer
You will find the answer elsewhere in this issue.
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