What is the significance of mild stenosis less than 50% in the mid Left Anterior Descending (LAD) artery, mixed plaque stenosis in the mid Circumflex (Cx) artery less than 50%, an enlarged aortic root measuring 4.1 cm, and an ascending aorta measuring 4.2 cm?

Differential Diagnosis

• Single most likely diagnosis
  • Atherosclerotic heart disease: This is the most likely diagnosis given the presence of mild stenosis in the LAD and mixed plaque stenosis in the circumflex, both of which are less than 50%. These findings are consistent with early atherosclerotic disease.
• Other Likely diagnoses
  • Hypertensive heart disease: The enlarged aortic root and ascending aorta could be related to long-standing hypertension, which can also contribute to the development of atherosclerosis.
  • Aortic ectasia: The dilatation of the aortic root and ascending aorta could be due to aortic ectasia, a condition characterized by dilatation of the aorta without significant aortic regurgitation or dissection.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Aortic dissection: Although the aortic dilatation is not severe, aortic dissection is a life-threatening condition that must be considered, especially if there are symptoms such as chest pain or if the patient has a history of hypertension or aortic disease.
  • Marfan syndrome: This genetic disorder can cause aortic dilatation and increase the risk of aortic dissection. Although it may not be the most likely diagnosis, it is crucial to consider it due to its potential severity.
• Rare diagnoses
  • Takayasu arteritis: This is a rare form of large vessel vasculitis that can cause aortic dilatation and stenosis of the coronary arteries.
  • Ehlers-Danlos syndrome: This genetic disorder can cause aortic dilatation and increase the risk of aortic dissection, although it is less common than other conditions.