Echo Reports Showed Dilated Aortic Report. What Does It Mean? Being Over Weight Will Harm?

Posted on Fri, 6 Jul 2012

Question: Dear Doctor, Guide me for following-
In my latest Echo reports shows that Aortic Root was dilated, LA diam shows 40mm, Ao Diam 43 mm, Ao asc 37 mm, however report says image quality was poor, what does this mean, in my previous Echo dated Feb,10.2012, which is on file shows Aortic Root 4.2cm ,and Echo January 2010 shows Aortic Root 39 mm this report is also on file, Does changes in Aortic root diameter shows in present and latest Echo is serious showing that changes in Aortic developed at quite fast pace. my age 53 plus, no doubt I am overweight, does this means that Aortic root will increased in diameter with weight, My weight is at same level for last many years.
What are other tests to be done? Does this requires urgent assessment?,or this is normal in age and weight.
Does Aortic root diameter as mentioned above is linked with valve type concerns.

Answered by Dr. Shanthi E (7 hours later)

Hi,

The normal diameter of adult aortic root is 3.6 cm (range 2.4 to 4.7 cm).

The latest measurement of your aortic root diameter is 43mm, the report dated February 10th 2012 shows the same thing at 42mm. The earlier report in January 2010 shows it at 39mm.

All the 3 values are within the normal range, highest being at 43mm. This is not a serious change and has not developed at quite a fast pace.

Let me suggest you one option, please upload the full echocardiography report with this query. I will be able to study it precisely and suggest you better.

The meaning of the sentence - "Image quality was poor" is nothing but the findings on Echo are not very clear either due to problem in the echocardiography machine or any other external factors. It simply means to say that the ECHO has to be repeated.

Weight gain has an effect on Cardiac condition though it may not be directly proportional to increase in diameter of the aortic root.

You may require a repeat echocardiography to be done, it is not urgent though.

There is no reason for an immediate assessment at the ER level also.

This may be considered safely as normal age related process and may not require any surgical intervention at all.

The root diameter is not linked with the valve type.

Please upload the reports and we shall discuss further. I also need to know about the present Ejection fraction (EF) of your heart to assess in depth.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanthi E (8 hours later)

Dear Dr.Shanthi,
Thanks, Reports enclosed, more reports like Blood tests,MRI cervicle spine, Ultra Sound of Parotid, kidney, abd /pelvic,can be sent under second follow up, I have ESR and CRP always high during last three years, having hematuria with dysmorphic red blood cells in urine, adema-legs and ankles, joint pain.headache front both sides. C4 high, and IgM low some time,, Parotid gland shows some inflammatory changes with Submandibular glands.
now Cardiologist asked for chronic venous insufficiency R and L, not done so far. Here in Canada health care is at very bad shape, any way.

Answered by Dr. Shanthi E (11 hours later)

Hi XXXXXXX

Thanks for uploading the reports, I have studied them carefully.

Let me take up the reports one by one and make it as simple as possible to you.

1. Carotid ultrasound - Both the XXXXXXX and external carotid arteries (right and left) are normal. There is no evidence of plaque. They are clear with good flow.

2. ECHO report dated 03/04/2012 - aortic root diameter is 43mm which is a bit more compared to the reference value of the lab (24 to 37). However, clinically the higher limit is considered as 47mm as I mentioned in my earlier reply. This has to be observed over a year or so. No intervention is required until and unless you experience any symptoms. Repeat the ECHO as suggested by your doctor.

Ascending aorta measures 37mm which is just above the normal of 36. Do not worry about this value.

Good news is that your left ventricular function is very effective. Left ventricular size, wall thickness and overall systolic function is normal with an EF (Ejection Fraction) >60%. I am very happy with this value.

3. Left parotid gland ultrasound dated may 18 2011 - inflammatory change is noted. It should have disappeared by now. You should not bother much about this.

4. ECHO dated 18th January 2010 - aortic root is 39mm. It is upper normal to mildly dilated as per the report.

5. ECHO dated 10th February 2012 - aortic root is 42mm.

Overall I see that your aortic root diameter is on the higher end, however clinically not significant for any cardiac intervention as of now.

Your present weight is 106 kgs. You need to shed some kilos.

The edema in your legs and ankle seem to be due to hypothyroidism.

Please get a PSA (Prostatic Specific Antigen) test done to rule out prostate conditions which are common in your age.

Hope this helps.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanthi E (7 hours later)

Thanks Dr.Shanthi,
Very informative reply, What do you suggest for weight reduction, I am pure veggie, diet is very normal, cortisol test was done in past it was normal.
Does Synthroid 25mcg daily one is sufficient ? Will ask for PSA test. See if you can give your contact inf, will contact you while in India next month.going to see Neurologist,Urologist and Kidney specialist in next few days ,will let you know for their latest opinion.

Answered by Dr. Shanthi E (16 hours later)

Hi XXXXXXX

Weight reduction can be achieved with a right diet and daily exercise. Please plan a daily routine with a right diet chart for you together with an exercise regimen. You may seek the help of an expert dietitian on this.

I suppose the current dosage of Synthyroid is sufficient for you as prescribed by your doctor. To confirm on it, we need to repeat the thyroid function tests.

You can find my details at WWW.WWWW.WW
It's my pleasure to help you.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar