Hey OP,

R15 (sonographer) here again.

OK, a few things are really jumping out at me.

First, the article you linked where it's talking about the 2.0 measurement being the average is talking about the ascending aorta, while your scan is talking about the aortic root. Those are two different things. The aortic root is the very beginning of the aorta, where it meets with the left ventricle. It consists of three basic landmarks: the aortic annulus, the Sinus of Vasalva, and the sinotubular junction. The annulus is the very, very start of the aorta, where the aortic valve is. If the aortic valve is the door between the left ventricle and the aorta, the annulus is the door frame. Then the vessel immediately widens, and the center of that widened area is the Sinus of Vasalva, which is what I've always been taught is the proper place to measure the aortic root. I'm pretty sure that is where the 3.7 cm measurement they obtained on you is referring to. Then it immediately narrows again, and the point where the root ends and the ascending aorta begins is called the sinotubular junction.

So, think of two parentheses facing each other. Then, imagine them rotated until one is on top of the other, so you basically have a circle with the right and left ends chopped off. The left-most measurement between the two parentheses would be the aortic annulus. The very center of the parenthese, where the distance between the two is greatest, is the Sinus of Vasalva. And the right-most measurement between the two parentheses is the sintotubular junction. And from there, the ascending aorta begins.

Long story long, you are looking at the measurement from your scan, which represents the Sinus of Vasalva, and comparing it to what is supposedly the average measurement for the ascending aorta...two completely different parts of the aorta. And you are thinking "oh my God, my aortic root is nearly double the size it's supposed to be! It should be about 2 cm, and it's nearly 4cm!" No wonder you're freaking out.

Second, it looks like you are comparing two different units of measure as well. I'm not 100% sure what cm/m2 actually represents, but I'd venture to guess it's a volume measurement (math peeps, feel free to correct me on this), which you're then comparing to a straight point-A-to-point-B diameter measurement. (Don't feel bad, when I was in school, the professors would routinely put this kind of question, sneaking in a different unit of measure, on tests to trip us up, because it's such an easy mistake to make.)

Third, again, I just want to reiterate to you that a 3.7 cm aortic root diameter is nothing to be alarmed about. According to the cardiologist I work for, it's the high end of normal. Apparently according to some others, it's a tad above normal...a very mild dilation. I had a patient this past Tuesday whose aortic root measured 4.2 cm, with a 4.0 cm measurement on the ascending aorta. The reading physician on the report referred to both as mild enlargements.

I don't know how accurate CT scans are when it comes to measuring the aortic root, but I wouldn't even take that measurement as gospel. Get an echocardiogram done for confirmation of that aortic root measurement. Worse case scenario, it's something you keep an eye on by getting it checked every year or couple of years. They don't even consider it as something that requires surgical repair until it reaches 5.5 cm, so you're very far from being in any danger.

Thanks for getting back to us and letting us know what's going on.