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Enlarged Aorta

37 years old, 6'6" tall, 220lbs, no history of heart problems.
I've been going through quite a few tests to rule out Marfan Syndrome. It has been 3 years of tests and I haven't recieved a definitive answer on Marfan!
My doctor at Yale Medical Center put me through fifth ECG and noticed what appeared to be a "bulge" on aortic arch. This bulge was never picked up on previous ECG's or CT scans. He wanted to get a more definitive image of bulge so MRA was ordered. MRA results:
-heart normal in size
-great vessels origin unremarkable
-aorta measured: aortic root 3.8cm,ascending aorta at level of right pulmonary artery 3.7cm,descending aorta at level of left pulmonary artery 2.2cm and descending aorta at level of diaphragmatic crus 1.5cm.
Aortic root is minimally ectatic. No evidence of aneurysmal dilatation seen in remainder of ascending aorta, aortic arch or descending thoracic aorta. No evidence of aortic dissection.

My doctor then ordered an aortogram to get a definitive image of the aortic arch.  I had that done Thursday and preliminary results:
-slightly generous proportions at end of ascending aorta.  No evidence of aneurysm or artherosclerotic disease.
The interventional cardioligist asked me if I wanted hime to "shoot coronaries" while in there, I said no.

1)CT scan measured as high as 4.5cm in ascending aorta. Why is MRA so different?
2)Is ascending aorta normally this large compared to descending?
3)Should I've had coronaries imaged?
4)Femostop used for femoral closure. Is brusing around site and base of scrotum normal?
5)Do I have Marfan?
Thank you!
30 Responses
74076 tn?1189759432
Hi Bob,

Sorry to about your medical concerns.  Marfan's can be a tough diagnosis to make.

1. CT scan measured as high as 4.5cm in ascending aorta. Why is MRA so different?

I can't give you a good answer for this.  They should read about the same.

2)Is ascending aorta normally this large compared to descending?
It sounds like your ascending aorta is a bit large.  They usually are not that different.

3)Should I've had coronaries imaged?
I wouldn't have.  If you ever need your aorta replaced, you will likely need to have your coronaries imaged, but you are not there yet and it is hard to say if you will ever need it replaced.

4)Femostop used for femoral closure. Is brusing around site and base of scrotum normal?
No it isn't normal to have bruising around your scrotum.  there must have been some bleeding but if it is not getting larger it should not be a concern.  It may expand a little and turn a greenish-blue color, this is normal.

5. I can't answer this one.  This is a tough questions and would require a thorough history and physical with test review, but even then it sounds like you are borderline at most.

I hope this helps and good luck.
Avatar universal
Bob, glad to see that the MRA provided you with good news. You will need to have your aorta monitored to make sure that the dilation does not progress to dangerous levels. Talk to your cardiologist about how often he wants follow-up MRA's. CT's expose you to a considerable amount of X-radiation that the MRA's avoid.
Avatar universal
Thanks for your concerns and comments pbanders.

Did you have your aorta monitored with the MRI or ECG?  I not only had the MRI completed, I also had an aortogram last week.  I still have bruises from some blood loss but the procedure was fairly quick and simple.  I haven't heard back from my cardiologist as to how I will be monitored.  I am hoping it will be with the MRI because the invasive approach of the aortogram(angiogram) is not my first choice.
The interventional cardiologist who did the aortogram Thursday commented on the initial report that there were no aneurysms and no artheroscerotic disease present but that the end of the ascending aorta had "slightly generous proportions".  I have seen this "larger" measurement in this area of the aorta three years ago on a CT scan.  It doesn't appear to have gotten larger over three years but I have not received a final report for the aortogram which I assume will have measurements of this area.  Have you ever had an aortogram done for your aortic root?

Thanks again!

Avatar universal
Bob and everyone Do you know what are normal ranges in cm for aortic root,ascending and descending thoracic aorta in average middle age men by mri/mra?What iv contrast was injected during mri/mra test and how did it feel,any allergy?Was your aorta imaging done as heart mri/mra or as chest mri/mra?Thanks
Avatar universal
I've been trying to post a question for quite some time, however when I heard of this situation I just wanted to provide some feedback.  My condition is like yours, I have an enlarged Aortic valve and arch.  My valve is at 4.5 and my arch is at 5.2, I have been told that I have to have my aortic valve and part of the arch replaced.  I am 39 years old and quite active, needless to say that has come to a halt.  I hope you find out what's going on because I'm going stir crazy and I just found out my situation 3 weeks ago.
Avatar universal
I'm due for my first follow-up MRA on 2/1, so I'll post again in the comments to this question and let you know what type of contrast was used, if any.

As for "normal" sizes, your cardiologist should be your first source for that information. In my case, a 5.0 cm dilation of my ascending aorta by CT w/contrast was sufficient to warrant surgery.
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