There is a broad differential for thoracic aortic dilatation.
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Differential diagnosis
- senile ectasia
- hypertension
- post-stenotic dilatation, e.g. bicuspid aortic valve
-
thoracic aortic aneurysm
- atherosclerosis (usually descending thoracic aorta)
- collagen disorders
- Marfan syndrome
- Ehlers-Danlos syndrome (classically involves sinuses of valsalva)
- aortitis
- syphilis (calcification common)
- mycotic aneurysm
- traumatic pseudoaneurysm (usually at aortic isthmus)
- aortic dissection
Practical points
There are a number of mimics of thoracic aortic dilatation:
- mediastinal mass
- pulmonary mass abutting aorta
Note: the thoracic aorta is not normally seen on frontal chest radiograph in patients <40 years of age.
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