I’m not a doctor, but I am a fellow patient who survived a catastrophic Type A aortic dissection in 2015, and I’ve been living with a surgically repaired ascending aorta ever since.

So here’s the deal: a 3.5 cm ascending aorta is technically still in the “normal” range for most people. The average is around 2.5–3.0 cm, and you don’t usually get truly worried until you’re talking 4.0 cm and up. That said, the key word in your report is “ectasia,” which means there’s mild dilation—not an aneurysm yet, but something to watch.

What bothers me isn’t the number—it’s the nonchalance. When the CT report says the aorta is "somewhat prominent compared to the descending aorta and body habitus,” that’s not something to shrug off for two years. At a minimum, you deserve a baseline echocardiogram now, so there's a clear reference point for the future. Two years without that is too long, especially at 62 and with controlled hypertension.

It also never hurts to get eyes on this from someone who does evaluate aortas for a living—namely, a cardiologist who specializes in dissections or BETTER YET a thoracic surgeon with aorta expertise. You’re not being dramatic or anxious. You’re being smart. A referral now means you’ll be seen if the aorta grows or changes. If nothing happens? Great. But if it does, you’ll be ready. I get CT scans every single year with contrast to monitor for changes.

Bottom line: trust your gut. You’re not overreacting. Ask for that echo and a cardiology referral. It’s your body, and this is too important to treat like a background issue. Peace.