Aortic Root Dilatation With Healed Aortic Root Abscess, Asymptomatic for 41 Years.

A 61-year-old patient presented to us with complaints of mild fever, rhinorrhea, sneezing, and dry cough. On auscultation, there was harsh vesicular breath sound with bilateral audible wheezing but no crackles. Also, a soft high-pitched early diastolic decrescendo murmur in third intercostal space on the left side, typical of aortic regurgitation (AR) was heard. History revealed that in 1976 he was diagnosed with AR and later in 1990 he was diagnosed with aortic root dilatation (AoD) with healed aortic root abscess (ARA). He had no history of infective endocarditis and has remained asymptomatic. The latest echocardiography revealed mild left ventricular hypertrophy (LVH) with Grade 1 LV diastolic dysfunction but no left ventricular (LV) wall motion abnormality. The patient was advised to take tablet losartan 20 mg OD to arrest the progression of his mild LVH and its related complications and continue with his lifestyle management and routine echocardiography.  In some rare cases, AoD with healed ARA can remain asymptomatic over the course of decades. Regular follow up exams (every one to two years), with proper management, is the mainstay of management, along with the treatment of comorbid conditions.