Aortic arch syndrome

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Aortic arch syndrome

Definition

The aortic arch is the top part of the main artery carrying blood away from the heart. Aortic arch syndrome refers to a group of signs and symptoms associated with structural problems in the arteries that branch off the aortic arch.

Alternative Names

Subclavian artery occlusive syndrome; Carotid artery occlusion syndrome; Subclavian steal syndrome; Vertebral-basilar artery occlusive syndrome; Takayasu disease; Pulseless disease

Causes

Aortic arch syndrome problems can be due to trauma, blood clots, or malformations that develop before birth. These defects result in abnormal blood flow to the head, neck, or arms.

In children, there are many types of aortic arch syndromes, including:

Congenital absence of a branch of the aorta
Isolation of the subclavian arteries
Vascular rings

An inflammatory disease called Takayasu syndrome may result in narrowing (stenosis) of the vessels of the aortic arch. This typically occurs in women and girls. This disease is seen more often in people of Asian descent.

Symptoms

Symptoms vary according to which artery or other structure that has been affected. Symptoms may include:

Blood pressure changes
Breathing problems
Dizziness, blurred vision, weakness, and other brain and nervous system (neurological) changes
Numbness of an arm
Reduced pulse
Swallowing problems
Transient ischemic attacks (TIA)

Treatment

Surgery is often needed to treat the underlying cause of aortic arch syndrome.

References

Braverman AC, Schermerhorn M. Diseases of the aorta. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 42.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Cutaneous vascular diseases. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 35.

Langford CA. Takayasu arteritis. In: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 165.

Review Date: 5/8/2022
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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