Q. What does an enlarged aorta indicate on a routine X-ray?

Answered by
Dr. Ruchi Sharma
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 18, 2023

Hello doctor,

I recently had an X-ray done to check for scoliosis, but I incidentally noticed that my ascending aorta appears to be enlarged. Am I looking at this right? What should I do in this case?

Please help.



Welcome to

I went through your query and understood your concern.

I have seen your chest radiographs, PA (postero-anterior), and lateral views (the attachments removed to protect the patient's identity) and have made the following observations:

1. There appears to be an unfolding of the aorta, which means that the arch of the aorta appears widened. However, having said that, I would not make a hasty inference based on this particular x-ray because I also noticed that there is some amount of patient rotation toward their right side, which means that the radiograph is slightly off-centered, which might be making the aorta appear enlarged in size than it is.

2. Also, deformities of the thoracic cage and spine can lead to misinterpretation of the sizes of mediastinal structures such as the heart and the aorta.

An unfolding arch is not a pathology and should not be mistaken for a definitive sign of an aortic aneurysm. It is a common finding in elderly patients associated with aortic calcifications and is a sign of atherosclerosis. Therefore, there is no need to be concerned about this in an asymptomatic young patient.

So I suggest you do a repeat X-ray with proper centering etc., or an echocardiogram. The advantages of an echocardiogram would be that there is no radiation involved, it would give accurate measurements of the ascending aorta, descending aorta, aortic arch, etc., in addition, it would analyze the heart function. I also suggets you consult a specialist and talk with them.

I hope this has helped you.

Thanks and regards.

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