Senile ectasia of aorta

Case contributed by Dra Cristina Ferreira

Presentation

Patient presents with dysphonia.

Patient Data

Age: 86
Gender: Female
Modality: X-ray

There is a markedly thoracic aorta ectasia, especially in the ascendant and aortic arch, with diffuse parietal atherosclerotic calcifications. 

An increased cardiothoracic ratio as a result of enlargement of the cardiac silhouette due to pericardial effusion.

Lungs are clear.

Case Discussion

Radiography chest shows a common finding observed in elderly patients - atherosclerotic senile ectasia of the thoracic aorta. In this case is causing compressive mass effect on the left recurrent laryngeal nerve and consequent paralysis of the vocal cord.  This is termed Ortners or cardiovocal syndrome.

The term aneurysm is used when axial diameter of the thoracic aorta is >5 cm and when it measures 4-5 cm the term dilatation is used 1.

Asymptomatic aneurysmal dilatation <6.5 cm is treated conservatively, and monitoring every 6-12 months. The choice of imaging techniques for evaluation of this pathology are CT and MRI with contrast. If the aneurysm is >6.5 cm, has annual growth >1 cm, or is symptomatic, intervention is considered because of the risk of rupture. In general, when possible, endovascular repair is the treatment of choice, with reduced morbidity and mortality 2

 

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Case Information

rID: 46520
Case created: 6th Jul 2016
Last edited: 7th Jul 2016
Systems: Vascular, Chest
Inclusion in quiz mode: Excluded

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