Pediatria pre prax 6/2020

Less common cause of respiratory stridor in newborn

Respiratory stridor is a serious clinical problem in newborns. The most common causes of respiratory stridor in the neonatal period are tracheomalacia, laryngomalacia, and anomalies of the aortic arch (vascular rings). The vascular ring is the result of a disorder in the embryonic development of the aorta and its segments. The clinical picture of a patient with a vascular ring depends on the degree of compression of the airways and esophagus. The vascular rings are in many cases aymptomatic, the most common symptoms are respiratory stridor, dyspnoic breathing and vomiting. The authors describe a case report of an immature neonate who had severe respiratory difficulties from birth requiring prolonged artificial lung ventilation. Using several imaging examinations (CT angiography, tracheobronchoscopy), it was found that the unfavorable clinical condition of the newborn was caused by dextroposition of the heart with subsequent compression of the trachea by the dislocated branches of the aortic arch. After performing aortopexy at the pediatric cardiocenter, the patient’s health gradually improved.

Keywords: respiratory stridor, vascular ring, echocardiography