A rare case of right aortic arch with mirror-image branching and vascular ring in an adult patient.

A right-sided aortic arch with mirror-image branching is a rare vascular anomaly, often associated with congenital heart defects. However, its occurrence with a vascular ring in the absence of cardiac abnormalities is extremely rare. We report the case of a 62-year-old male presenting with acute dyspnea, in whom CT angiography revealed a right-sided aortic arch with a vascular ring formed by an aortic diverticulum and the left brachiocephalic artery, causing mild tracheal and esophageal compression. Echocardiography confirmed the absence of cardiac anomalies. This case highlights a rare presentation of a right-sided aortic arch with a vascular ring in an adult patient. While often asymptomatic, such anomalies may contribute to airway or esophageal compression, warranting careful imaging evaluation and tailored management.