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Kommerell’s Diverticulum with aberrant right subclavian artery

Posted by Jackie Bell @jbell22, Feb 7, 2017

I have a right facing aorta with an abhorrent left subclavian artery and a kommerellis diverticulum. I have had one surgery and am looking at more. My question/query is this: does anyone with a heart condition get heart pain just from talking? The more I talk (just with friends, on the phone etc) and the louder I talk increases my pain. My surgeon is suggesting now that I might have an aorta which is attached to my breastbone and I might now need an aortapexy - symptoms being the talking issue. Anyone familiar with this? ☺

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jeanern01 | @jeanern01 | Aug 31, 2023
In reply to @pinkcarmen "Thank you so much, I am looking for other doctors for consults. Have not contacted the..." + (show)
@pinkcarmen

Thank you so much, I am looking for other doctors for consults. Have not contacted the Cleveland clinic yet but I will, Thank you for the suggestion. You mention your ARSA does not affect your esophagus, Have you gotten chest pain or any other symptom caused by ARSA.?

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@pinkcarmen, I had no symptoms. It was only found incidentally because of my other congenital symptoms. In fact I would not had it repaired if it hadn’t been in the way- I had a large kink in my aorta and the ARSA just happened to be where the graft would end, so they had to move it. I had no rings, or aneurysm. I was told this is why it is rare- more patients with ARSA are like me- no symptoms and never know they have it. It is also why when diagnosed it’s probably not taken too seriously or investigated properly by some drs. But you know your body and symptoms- and yours is definitely impinging on other structures- keep reaching out to other places for more opinions. Have you had a CT angiogram? Or Swallow studies, I had MRI, and CT scans to really visualize mine, they were able to say for sure no ring and no other structure involvement- so more studies may help secure your diagnosis as well. Hope this helps!

Jeane

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mrsr1234 | @mrsr1234 | Sep 19, 2023

Ok, so, I had surgery to repair both left & right aberrant vessels Nov 2022, TEVAR to place stents Apr 2023.... no one and I mean NO ONE said to me (or my husband) that the symptoms could or would return. Because the dysphasia is back like it never left. Had yet another barium swallow yesterday (radiologist said: oh, you're back? yes, yes I am) which showed the stump of the ARSA w/ stent (still) pressing into my esophagus. -prior to the study, I asked the surgeon about the symptoms was told: "We do often see that symptoms either never get better or reoccur after treating the aneurysm due to the changes on a muscular level from the chronic compression." Well, that would have been nice to know. Also having upper endoscopy Nov 1st so that'll be a hoot.
Anyone else run into this?

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meagankyla | @meagankyla | 3 days ago
In reply to @jeanern01 "Hello @pinkcarmen I think it is important to have some more studies done. ARSA is rare..." + (show)
@jeanern01

Hello @pinkcarmen
I think it is important to have some more studies done. ARSA is rare to find but actually more common just not usually diagnosed. Not everyone has an ARSA that rings or affects the esophagus- majority of them I think are like mine simply in the wrong place but work fine and have to impediment on other structures- which leads normal cardiologist to brush them off sometimes. Reach out to major cardiology centers- if you’re not happy with Mayo try Cleveland Clinic. I got my second opinion from them- they also deal with less common cardiology issues more often. Don’t give up- you are your best advocate and know your body best- and you will find a medical team you feel comfortable and secure with- unfortunately it may take to searching though.

Jeane

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It was recently confirmed that I have ARSA. I consulted a cardio thoracic surgeon that said my ARSA can’t possibly be the cause of my pain due to no rings or affecting my esophagus. And with that opinion my GP told me that she thinks my ARSA is a ‘dead end’ to my symptoms.
Reading your advice has given me hope as I do believe it makes sense that the ARSA may not be the direct cause, but is an impediment.

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