Effect of exercise on asymptomatic children with an isolated aberrant subclavian artery.
OBJECTIVE
An aberrant subclavian artery (aSCA) is the most common congenital anomaly of the aortic arch. Most cases are asymptomatic and found incidentally.This study was conducted to estimate the occult exercise-induced oesophago-tracheal compression (EIETC) in children with isolated aSCA found by screening echocardiography.


METHODS
A total of 42 asymptomatic children with isolated aSCA, aged from 6.8 to 16 years, were studied in 2007. Barium oesophagography, echocardiography and magnetic resonance angiography or computed tomography were used to confirm this anomaly. In order to estimate the occult EIETC, we conducted a protocol of pulmonary function tests (PFTs), a feeding test and a treadmill exercise test (TET) on the patients.


RESULTS
All of the children could be diagnosed by both barium oesophagography and echocardiography. Six (14%) patients had a globus sensation before testing. None had a history of inspiratory stridor, failure to thrive or dysphagia. No complications developed in this study.An additional patient had a globus sensation after TET, but none had dysphagia, chest pain, dizziness or dyspnoea. Response to exercise was normal, feeding tests were normal and there were no significant changes in the results of PFTs or the grade of respiratory impairment after exercise.


CONCLUSIONS
Based on the function tests used, there is no evidence of EIETC and cardiopulmonary deficits in the patients with isolated aSCA. These findings support the known concept not to operate asymptomatic patients with an isolated aSCA found incidentally by screening echocardiography and that there is no increased risk of cardiopulmonary decompensation under defined exercise.
Jan
Sheng-Ling
SL
Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan. sljan@vghtc.gov.tw
Lin
Shing-Jong
SJ
Fu
Yun-Ching
YC
Tsai
I-Chen
IC
Chan
Sheng-Ching
SC
Lin
Ming-Chih
MC
D000293:Adolescent; D002648:Child; D004452:Echocardiography; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000209:etiology; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D033162:Incidental Findings; D018810:Magnetic Resonance Angiography; D008297:Male; D008403:Mass Screening; D011237:Predictive Value of Tests; D011859:Radiography; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013348:Subclavian Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging