UMEM Educational Pearls

Category: Vascular

Title: Aortic Root Measurement

Keywords: aortic aneurysm; point-of-care ultrasound; pocus; aortic dissection (PubMed Search)

Posted: 12/4/2023 by Alexis Salerno, MD (Updated: 7/12/2024)
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Point-of-Care Ultrasound can help to identify signs of thoracic aortic dissection.

One view to help in your assessment is the Parasternal Long Axis View.

  • The aortic root should be in a 1:1:1 ratio with the left atrium and the right ventricle.
  • The aortic root should be less than 4 cm (4.5 cm considered aneurysmal)

To correctly measure the aortic root:

  • Measure at the Sinus of Valsalva
  • Measure during diastole (when the aortic valve is closed)
  • Measure leading edge to leading edge

Here is an example of an aortic root aneurysm: 


Kennedy Hall M, Coffey EC, Herbst M, Liu R, Pare JR, Andrew Taylor R, Thomas S, Moore CL. The "5Es" of emergency physician-performed focused cardiac ultrasound: a protocol for rapid identification of effusion, ejection, equality, exit, and entrance. Acad Emerg Med. 2015 May;22(5):583-93. doi: 10.1111/acem.12652.