Tortuous Aorta Picture: Pushing The Limits of Human Pathology!

The aorta is the main artery of the body that exits the heart and delivers blood to every organ of our body.    I will often see radiologists dictate "tortuous aorta"  on my radiology film reports.  What does it mean to have a tortuous aorta?  That finding is documented when the  aorta that curves back and forth as it descends down the trunk of the body instead of passing down in a fairly direct path.  Here is a picture below  of 94 year old lady who has never been admitted to a hospital.  Not once.  Not ever.  In fact she delivered her children from home.  You can see her vertebral bodies down the middle and her heavily calcified and tortuous abdominal aorta whipsawing back and forth as it descends down the body. I think I even see an aneurysm near the bottom as well as what I think are her calcified iliac arteries as well. This is right up there with that crazy case of severe scoliosis

This level of  calcification is a marker for a heavy burden of atherosclerosis. What does that mean? It means she is at a higher risk of having an "attack" of any organ where blood vessels go.  Most commonly, these attacks occur as strokes, heart attacks and or  peripheral arterial disease related claudication or acute ischemia.  The fact that this lady has such an impressive burden of vascular disease and has lived independently  to the ripe young age of 94 by avoiding American health care is a testament to the power of doing nothing. As physicians, we need to keep that perspective fresh the next time we have the urge to fix someone.  Often, we just end of breaking them.  I guarantee this lady would have died decades earlier had we gotten our mittens wrapped around her and tried to straighten out her crooked, calcified and tortuous aorta.  

Tortuous and heavily calcified tortuous aorta in a 94 year old

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