title: Perinatal/Neonatal case presentation: pulmonary artery sling associated with respiratory distress.
abstract: Pulmonary artery sling is a very rare cause of pediatric respiratory distress. The estimated prevalence of the disease was first determined by Yu et al. in 2008 as 59 per million school-aged children. Associated symptoms are cough, wheezing, and feeding difficulty, all of which are common in routine outpatient pediatric clinical encounters. We report a case of a premature male neonate twin who was admitted to the neonatal intensive care unit with respiratory distress and pneumothorax. His presentation, as well as the etiology of his pulmonary disease, was felt to be consistent with those of numerous other premature infants. Akin to this was his delayed discharge on account of his slow progress with oral feeding. Parents gave a history of tachypnea and feeding difficulty to his doctors. He presented twice to the emergency room in respiratory distress. At 4 months of age, while in hospital for a pulmonary infection, he had an echocardiogram that revealed a pulmonary artery sling. We review the literature on this vascular anomaly, discuss its diagnosis and management, and critique the clinical thinking that determined this child's course from the perspective of availability heuristics.
authors.affiliation: Division of Developmental Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA USA.
authors.forename: David
authors.initials: D
authors.lastname: Healey
authors.affiliation: Department of Pediatrics, New York Methodist Hospital, 506 Sixth Street, Brooklyn, NY 11215 USA ; Weill Cornell Medical College, New York, NY USA.
authors.forename: Nitin
authors.initials: N
authors.lastname: Ron
authors.affiliation: Department of Internal Medicine, Elmhurst Hospital, Queens, NY USA ; Icahn School of Medicine at Mt. Sinai, New York, NY USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hromada
authors.affiliation: Department of Pediatrics, New York Methodist Hospital, 506 Sixth Street, Brooklyn, NY 11215 USA ; Weill Cornell Medical College, New York, NY USA.
authors.forename: Manoj
authors.initials: M
authors.lastname: Chhabra
keywords: Cardiovascular; Congenital; Developmental origins of health and disease; Infant; Neonate; Pulmonary artery sling; Stovepipe trachea