Double aortic arch presents with dysphagia as initial symptom.

![Figure][1] A 62-year-old woman presented with breathlessness and dysphagia. Routine chest x-ray showed a widening in the upper mediastinum that suggested a thoracic aorta enlargement. No cardiomegaly was found (A) . Transthoracic echocardiography revealed normal left ventricular systolic