Noninvasive echocardiography can have invaluable information prior to studies such as computed tomography or invasive angiography. A 23-year old man presented to our hospital with a chest x-ray showing widened upper mediastinum. Echocardiography demonstrated color flow jets in opposite directions, compatible with tortuous aneurysmal dilatation of the aortic arch at the cervical position. The 640-slice computed tomography later confirmed the developmental anomaly of cervical aortic arch.
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