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288 of uncontrolled asthma and to establish a relationship between vascular anomaly and asthma. The patient had a history of mild atopic asthma since childhood. The course of the disease aggravated at the age of 32 years, when she began to suffer from multiple, sudden episodes of shortness of breath, coughing, and wheezing. Within the last 7 years, she required 35 hospitalizations on that account, including 4 hospitalizations in intensive care units. Symptoms persisted despite treatment with high doses of systemic and inhaled corticosteroids. Chest computed tomography (CT) performed 5 years ago owing to suspicion of pulmonary embolism after a lower limb fracture revealed a vascular anomaly in the form of an ARSA. At first, it was not associated with troublesome respiratory symptoms; however, with time, the patient reported increasing difficulty swallowing solid Aberrant right subclavian artery (ARSA), also called arteria lusoria, is the most common congenital abnormality of large vessels branching from the aortic arch, which occurs with a prevalence of 0.5% to 2% of the general population.1 In infants, the disorder can manifest as stridor, wheezing, and recurrent respiratory infections due to the lack of sufficient rigidity of the trachea.1 In children, dyspnea or dysphagia can occur. In adults, this anomaly is usually clinically silent. When symptomatic, it produces dysphagia (dysphagia lusoria).2 The first case of an elderly woman with dysphagia caused by an ARSA was described in 1787 by Bayford.3 The predominance of dysphagia in adulthood may result from increased rigidity of the trachea, progressive atherosclerosis and stiffness of the ARSA, its tortuosity, or aneurysmal dilation.4 We report here a case of a symptomatic ARSA in an adult woman with asthma. A 39-year-old woman was admitted to the Department of Pulmonology to extend the diagnosis

Difficult-to-treat asthma and dysphagia in an adult patient with aberrant right subclavian artery