Brief Answer:
I would explain as follows:

Detailed Answer:

Hello!

Thank you for asking on HCM!

Regarding your concern, I would explain that increased bronchovascular markings is one of the most frequent signs encountered in pulmonary diseases.

The most common of them is an acute lung inflammation (infection), like acute bronchitis, or bronchopneumonia, COPD, sometimes bronchiectasis, but also some infiltrative and parenchymal lung disorders, etc. may show such a picture.

An important differential is with lung cancer, as imitation of increased bronchovascular markings may be present in the latter.

Nevertheless, it is important to always correlate clinical picture with other medical tests, as it may helpfully lead to the right diagnosis, differentiate an acute infection, from a chronic one; or rule in/out an infiltrative/ neoplastic disease, etc.

A comprehensive clinical evaluation (symptomatology and medical history) will appropriately lead to choosing correctly additional more sophisticated tests (than a simple chest X ray film) to better differentiate these general findings and get to the real diagnosis.

You need to consult with your doctor (internist or pneumologist) to properly make a clinical radiological correlation.

Regarding aortic unfolding sign, it is a normal finding especially with aging, and means a mediastinum enlargement as a result of aortic arch prominence on the right heart side; is explained with aortic topography changing with aging. Usually is a false alarm (without clinical significance).
Rarely a differential with an aortic aneurysm should be done.

I could give a medical opinion, if you would be able to upload your chest X ray film.

Hope to have been helpful!

Feel free to ask me whenever you need. Greetings! Dr. Iliri

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