Unusual case of “airway hyperreactivity” in a child with an incomplete double aortic arch with atresia of the left aortic arch

A 10-year-old girl had an obstructive breathing pattern with recurrent episodes of wheezing and stridor since infancy, identified and treated as hyperreactivity of the airways with little improvement. Clinical examination revealed a protosystolic ejection murmur (graded 2/6). Subsequent echocardiography revealed a dominant right aortic arch and an atretic left arch.