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REMEDY : BNSSG referral pathways & Joint Formulary

Dilated Ascending Aorta - DRAFT

Checked: 03-05-2022 by Rob.Adams Next Review: 03-05-2023

Overview

A dilated ascending aorta may be found as an incidental finding on imaging such as echo or MRI or during investigation of associated conditions such as:

If the patient is symptomatic then please review the Aortic Dissection page or see the Red Flag section below.

This page deals with management of patients who are asymptomatic.

 

Who to refer

Patients with asymptomatic dilatation of the ascending aorta (criteria to follow) should be referred routinely to Cardiology via eRS to discuss monitoring.

Red flags

Suspected aortic dissection

Any person with new onset pain who has a history of aortopathy (or diagnosed first degree relative), aortic dilatation, bicuspid aortic valve or with past aortic surgery should have an emergency CT aortogram to exclude aortic dissection.

What to do before referral

For patients with asymptomatic dilatation of the ascending aorta, please consider the following investigations as part of the work up:

  • ECG
  • CXR
  • Echocardiogram

Manage cardiovascular risks as appropriate.

Safety netting - advise the patient that if they develop chest pain then they should call 999 and attend their local emergency department immediately.

 

Referral

UHBW - Refer to Cardiology - Valve Clinic at the BRI via eRS (Dr Mandie Townsend).

NBT - Refer to cardiology via eRS.