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Ascending Aorta 3.5 cm
A recent CT (with and without contrast) for something else revealed a finding of an “Ascending aortic ectasia 3.5 cm, somewhat prominent compared to the descending aorta and body habitus..”
The Dr. who ordered the scan, referred me back to my Primary Care Physician for follow up on this finding as it was unrelated and out of his scope of practice. After following up with my primary care physician, he said he researched and conferred with another Dr. and they recommend waiting 2 years for another scan. No referral to a Cardiologist at this time.
After reading about the ascending aorta and possible related issues, I am still concerned. I want to trust my PCP, he has been my physician for quite a number of years and knows my history, but should I request further tests or a referral to a cardiologist? Just FYI, I am a 62 yr old female. Currently I take meds for high blood pressure and high cholesterol. Both are under control at this time.
Thank you in advance for your comments.
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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.
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3 ReactionsHello, I am a 65 year old female. I have the same issue that was found 6 months ago. Mine was measured at a 4.0-4.2. I just had another echo and it seems as if it hasn't changed but I am waiting to hear from my Cardiologist. I do not take any medication but I do take a lot of supplements. I am a little worried about this. trying to keep my BP down and cholesterol down. It is a bit scary. I am glad yours is lower. Don't worry
I am not a doctor but if it makes you feel you can have peace of mind then request your doctor refer you to a cardiologist. Sometimes having the conversation with a specialist can give you peace especially since you are taking meds for high blood pressure and high cholesterol. Share with your doctor how you would rather be proactive in your future health plan by speaking to a cardiologist.
Yes I agree Either go back to your PCP and ask for a cardiologist or just do your own research and find one. If you’re close to a university hospital you will likely find a good cardiologist and if need be a surgeon . Best
Hi, I was diagnosed with ascending aortic arch aneurysm. Have forgotten measurements. I was also very worried. Then I went to a Thoracic vascular surgeon. I also was 62. Female 5’ overweight but no problems with blood pressure or meds for anything but anxiety and adhd. The surgeon was great. He told me that were I two inches taller, it would be a normal sized aorta. And I could just get it checked annually. Perhaps you look into this type of doctor. Best wishes!