SYMPTOMS

What is dilation of the ascending aorta?

Based on the course of the aorta, a portion of it is referred to as the ascending aorta, which originates from the aortic orifice of the left ventricle and gives rise to the left and right coronary arteries at its root ^[1].

Normally, the diameter of the ascending aorta in adults is approximately 3 cm. If the inner diameter exceeds 3.5 cm, it is termed dilation of the ascending aorta ^[2,3]. If pathological dilation occurs, it may progress to an aortic aneurysm.

Generally, there are no obvious symptoms, and it is often detected during echocardiography. It is commonly caused by other conditions, such as hypertension or bicuspid aortic valve, where hemodynamic changes lead to compensatory dilation of the aorta, resulting in widening of the ascending aorta.

Is dilation of the ascending aorta serious?

If left untreated, dilation of the ascending aorta can progress, leading to aortic dissection or rupture, which poses a life-threatening risk.

European and American clinical guidelines recommend surgical intervention for patients with an ascending aortic diameter exceeding 5.5 cm. However, studies have shown that aortic dissection can occur even in patients with diameters below 3.5 cm ^[4]. Therefore, patients are advised to undergo thorough evaluation at a reputable hospital to determine whether surgery is necessary.

TREATMENT

How to relieve dilated ascending aorta?

• Lifestyle interventions

  • Lifestyle modifications include weight loss, eating more fresh vegetables (such as greens, spinach, etc.) and fruits (such as apples, oranges, etc.), engaging in physical exercise (such as walking, tai chi, etc.), reducing intake of sodium-rich foods and animal organs, quitting smoking, and limiting alcohol to prevent elevated blood pressure ^[3];

  • Ensure adequate rest and maintain a positive mindset.

It is important to note that if these measures fail to alleviate the dilation of the ascending aorta or if the condition worsens, prompt medical attention is necessary to further identify the underlying cause.

DIAGNOSIS

When should you seek medical attention for dilated ascending aorta accompanied by symptoms?

Seek medical attention promptly if dilated ascending aorta is accompanied by the following symptoms:

• Chest pain, abdominal pain, shortness of breath;

• Syncope, angina;

• Fever, dizziness, slurred speech;

• Other severe, persistent, or progressive symptoms.

Which department should you visit for dilated ascending aorta?

Cardiology or Cardiac Surgery.

What tests are typically performed for dilated ascending aorta?

• Ambulatory blood pressure monitoring: Primarily measures blood pressure to assess for hypertension.

• Echocardiography: Used to measure the degree of dilation and observe the location of the dilated ascending aorta.

• Angiography: Provides comprehensive, multi-angle, and clear three-dimensional visualization of the ascending aorta to rule out conditions like aortic aneurysm.

• Imaging tests: Including CT, X-ray, MRI, etc., to assist in evaluating blood flow in the heart and blood vessels.

POTENTIAL DISEASES

What are the possible causes of ascending aortic dilation?

• Hypertension: Increased peripheral vascular resistance leads to elevated cardiac output and workload, causing hemodynamic changes. During the compensatory phase, this may result in ascending aortic dilation ^[3].

• Aortic diseases: Conditions such as bicuspid aortic valve, atherosclerosis, and aortitis are often accompanied by ascending aortic dilation.

  • Bicuspid aortic valve: Congenital abnormal development of the aortic wall reduces the elastic recoil capacity of the vascular wall, or abnormal aortic valve structure alters hemodynamics, leading to ascending aortic dilation ^[6].
  • Atherosclerosis: Reduced arterial elasticity can cause lumen dilation, resulting in ascending aortic dilation or aneurysm formation ^[3].
  • Aortitis: Conditions like Takayasu arteritis or infectious aortitis primarily damage the intima and media of the artery, affecting the ascending aorta and potentially causing dilation ^[3].