Echocardiogram

[kyjon]

I had an echocardiogram done in August, because I was having chest tightness and pains in my upper chest. They notified me that the results were normal, although I do not know the specific numbers. Subsequently, a cardiologist evaluated the results and again said they were normal. My question is, can an echocardiogram detect any problems with the aorta? Should I ask for a ct-scan just to be sure? Can an echo also show the ascending aorta and arch?

[Cleveland Clinic]

The echo is decent for assessing the proximal ascending aorta.  The distal ascending aorta and the arch are very poorly visualized on echocardiography and typically need a different modality for thorough evaluation, CT being one of them.  Depending on the degree of suspicion for a thoracic aneurysm (the risk is probably low in you) one usually starts with a simple chest Xray for those who have low likelihood or goes straight to a chest CT in those who have intermediate or high risk.  

[kyjon]

Thanks for responding! I am suspicious of having Marfan's though I dont fit all criteria and have never had any serious heart issues. I have had two chest x-rays this summer also, and both came back normal. Can they detect any abnormalities or swelling of the ascending aorta/arch?

[Cleveland Clinic]

The xrays won't but as I mentioned earlier the proximal aortic root is well seen on echo.  The only way to see the arch well is either with a CT or an MRI.  Some cardiologist also do transesophageal echos for that as well, but that's a more invasive procedure and not as good as the other imaging modalities.