What clinical finding is associated with a vascular ring in infants?

A vascular ring often presents in infants with stridor that improves with neck extension. This phenomenon occurs because a vascular ring can compress the trachea or esophagus due to its position around these structures. In particular, when the neck is extended, the anatomical angle changes, potentially alleviating the pressure on the trachea and resulting in improved airflow.

In contrast, stridor that worsens in a supine position typically suggests conditions such as laryngomalacia or other airway abnormalities, which do not specifically relate to vascular rings. Hoarseness accompanied by normal breath sounds may indicate vocal cord issues but does not imply the classic presentation of airway compression caused by a vascular ring. Additionally, inspiratory stridor accompanied by respiratory distress could involve various airway obstructions that are not specific to vascular rings, making the improvement with neck extension a more unique and pertinent finding in this scenario.