Aortic Disease

Aortic disease is common and consists of pathologies that are both congenital and acquired in later life. Although often considered as a simple conduit between the heart and the end organs, the aorta may be afflicted by a myriad of processes including constrictive, degenerative, vasculitic, inflammatory and haemorrhagic conditions. These pathologies may have effects that are silent but harmful (e.g. chronic hypertension in coarctation) at one end of the spectrum with acute life threatening presentations (e.g. aortic dissection) at the other end. Although the ascending aorta is seen relatively well by echocardiography, the arch and descending aorta are relative blind spots where significant disease may be overlooked. CMR is the ideal tool for aortic scrutiny because of its large unobstructed field of view, multiplanar reprocessing capabilities and the range of techniques using both exogenous and endogenous contrast techniques for producing excellent 3D models which are readily understood by non specialists. Finally since the aorta is not an isolated tube but a structure with important ventricular interactions, the degree and consequences of aortic valve disease may be readily assessed at the same examination.