An aortic heart is a manifestation of the heart on the posterior anterior X-ray chest radiograph, in which the heart is boot-shaped, with a concave heart girdle, an enlarged lower left margin of the heart to the left, and a prominent aortic bulb presenting a manifestation commonly seen in hypertensive disorders and aortic valvular lesions. The change in shape and density of the heart is evident on chest radiographs. When vascular elasticity is reduced intra-aortic pressure increases, cardiac output increases, and the aorta dilates and lengthens. Over time, vascular tortuosity develops, and the increased intra-aortic pressure can act on the aortic wall to dilate the vessel. As in hypertensive disease, in some cases the effects are localized within the aorta.