Right aortic arch with aberrant left subclavian artery
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Chest pain and dyspnea with suspicion of pulmonary thromboembolism.
CT pulmonary angiography
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Scout view shows right aortic knob and arch as well as slight tracheal shift to the left, with cardiomegaly.
Pulmonary CTA demonestrating that the descending aorta continues inferiorly on the right side of the vertebral column. The aberrant left subclavian artery is the last branch to arise from Kommerell diverticulum at the distal end of aortic arch. The findings are consistent with a right aortic arch with aberrant left subclavian artery. Pulmonary arteries diameter is increased consistent with pulmonary arterial hypertention, cardiomegaly and moderate pericardial effusion are noted too.
Approximately 0.1% of population has right aortic arch, and about half of them have an aberrant left subclavian artery which may arise from aorta or diverticulum of Kummerell.