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Daniel Nelson, MD
Daniel Nelson, MD, Doctor (MD)
Category: Health
Satisfied Customers: 258
Experience:  Licensed MD. Mayo Clinic Rochester trained physician in Internal Medicine - Critical Care Medicine.
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Dilated, Tortuous Aorta on CXR in 53 y/o female My ...

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Dilated, Tortuous Aorta on CXR in 53 y/o female

My wife is white, 53 years old and spherical. She is only 5'' 5" tall and hugely over-weight. She normally enjoys good health until two months ago when she developed a chest infection that wouldn''t go away. She doesn''t smoke and has not, to our knowledge been exposed to asbestos or other industrial dangers. She was present and helped out in the imediate aftermath of 9/11 for three days when the air was very dusty.
BP is usually within normal limits, last record was 145/85 using a very large cuff.
Non productive cough. No fever. No clubbing. No cyanosis.
Bloods taken showed only elevated LDH at 262 (ref 90 - 180) but I thought this might be due to the extreem dificulty in getting blood out of her. Multiple attempts left her "bruised" all over her arms. CBC, Biochem otherwise normal.
She had PA and Lateral CXR''s.
CXR. Lungs well aerated etc. Pulmonary vascularity normal.
The patient is rotated on the frontal view. Right parenchymal soft tissue opacity is likely related to patient rotation. However, it could also be related to ectatic vasculature or soft tissue mass.
The thoracic aorta is tortuous and ectatic. Cardiac silhouette is normal
Impression. Right parenchymal soft tissue opacity on the frontal view probably related to manubrium proecting to the right due to patient rotation. However, ectatic vessels or other causes of soft tissue mass in a parenchymal location not excluded.
Question. What is the significance of the tortuous dilated aorta? Does it require further investigation?

Is there any possibility the parenchmal masses and LDH are related? Could the raised LDH {262 (ref 90 - 180)} be secondary to the difficulty in getting a blood sample. CBC entirely normal.
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