prominent ascending aorta in a young patient (patient less than 40 years of age)
the descending aorta (assessed on lateral film) has a disproportionately mild or even absent prominence
wide aortic arch
clues to the cause of an aneurysm include:
mild and generalized dilatation occurs with hypertension
in Marfan's syndrome - aneurysms generally occur in the ascending aorta and usually most marked in the region of the aortic sinuses. They result in aortic regurgitation
syphilis - aneurysms affect the ascending aorta. They are characterised by continuous, thin, curvilinear calcification (1)
atheromatous aneurysms - calcification consists of irregular, interrupted plaques. These forms of aneurysm are most common in the descending aorta
Reference:
Hampton J (1993). The patient with chest pain and breathlessness. Medicine International, 21(8), 289-91.
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