Thoracic aortic dilatation (differential)

There is a broad differential for thoracic aortic dilatation.

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
    • Takayasu arteritis
    • giant cell arteritis (GCA)
    • rheumatoid arthritis (RA)
    • ankylosing spondylitis
  • 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.

See also

• ascending aorta dilatation
• abdominal aortic aneurysm
• thoracic aortic aneurysm