Aortic nipple

Last revised by Liz Silverstone on 21 Apr 2024

Aortic nipple is the name given to the chest radiography appearance of the left superior intercostal vein as it courses over the aortic arch. This small convexity is seen in less than 10% of PA chest x-rays. The caliber of the vein normally changes with intrathoracic pressure and patient position.

Fixed dilatation occurs due to the increased flow associated with superior vena cava obstruction or absent azygos vein, a rare normal variant 3. The superior intercostal vein acts as a collateral pathway.

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