Pediatric Heart Expert Forum
Chance of vascular ring?
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Chance of vascular ring?

Our son is 5. He's always had a history of complaining that he can't swallow certain foods (meats like pork chop, roast feef etc), but otherwise had no issues. About 6 months ago he started making this noise, we originally thought he was clearing his throat (we've since been informed it is indeed a cough, as he noticeably inhales first. The cough can be seen here, at 0:45 and 1:30 in the clip):

http://www.youtube.com/watch?v=NyCZCHf4Qhc

Finally this summer, his GP suggested maybe it was post-nasal drip and that we try allergy meds. After a month on Claritin and Flonase there was no improvement. He went back for his follow up and she finally listened to his chest. While we can't hear it, with a stethoscope, she said she did definitely hear a wheeze in his chest. She said it "could be" asthma, but wanted to send him to a pediatrician to see what he thinks. In the meantime, she gave us a Salbuterol puffer to try during the "spells" to see if it helps. It's been two weeks, and it doesn't help at all. We've even tried cough suppressants, they don't help.

This cough happens all day, every day. Sometimes worse than others, he might go a couple/few hours and hardly do it at all, and other times it's almost constant. "Triggers" seem to be increased activity, shortly after eating, some nights laying down.

Someone mentioned to me that their child had a chronic cough similar to this and they ended up having this vascular ring. Could it actually be a possibility? What sort of tests would be needed for diagnosis? Should I ask the pediatrician to make sure it's ruled out?



773637_tn?1327450515
Dear MSHanson,

Without seeing your son, it is difficult to tell the cause of his swallowing issues.  This could be due to a vascular ring.  A chest X-ray can suggest abnormal arch sidedness, although a barium swallow usually can be diagnostic, although echocardiography can also demonstrate arch sidedness as well as the vessels off of the arch that can suggest a ring.  I think that it's a reasonable request to make of the pediatrician.
3 Comments
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Thank you. If they do just a general chest xray for his lungs, would the abnormal arch automatically be picked up, or would they have to be looking for it?
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773637_tn?1327450515
The arch sidedness would have to be looked for and (hopefully) commented on by the radiologist.
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