A PATIENT WITH MARFAN SYNDROME IS CONTEMPLATING PREGNANCY. WHICH OF THE FOLLOWING CLINICAL FINDINGS PLACES HER AT HIGHEST RISK FOR MORTALITY DURING PREGNANCY

• A. A grade 2/6 apical diastolic murmur with radiation to the axilla
• B. An aortic root diameter of 47 mm ✓
• C. Marked tricuspid regurgitation
• D. Unifocal premature ventricular contractions

In a patient with Marfan syndrome contemplating pregnancy, an aortic root diameter of 47 mm places her at the highest risk for mortality during pregnancy. Marfan syndrome is a genetic disorder that affects the body’s connective tissue, including the heart’s blood vessels. Aortic root dilation is a common manifestation of Marfan syndrome and can lead to life-threatening complications such as aortic dissection or rupture, especially during the hemodynamic changes of pregnancy.

An aortic root diameter of 47 mm indicates significant dilation and poses a substantial risk during pregnancy due to the increased hemodynamic stress on the heart and blood vessels. Pregnancy itself causes physiological changes that can further strain the already weakened connective tissue in individuals with Marfan syndrome, increasing the risk of aortic dissection or other cardiovascular complications.

Monitoring and managing the aortic root diameter closely before and during pregnancy are crucial in patients with Marfan syndrome to minimize the risk of adverse outcomes. Regular follow-up with a cardiologist specializing in connective tissue disorders is essential to assess the progression of aortic root dilation and determine the appropriate timing and mode of intervention if needed to reduce the risk of mortality during pregnancy.

Therefore, among the clinical findings listed, an aortic root diameter of 47 mm presents the highest risk for mortality in a pregnant patient with Marfan syndrome due to the potential complications associated with aortic dilation and increased hemodynamic stress.

In other words, Marfan syndrome is a genetic disorder that affects the body’s connective tissue. It can impact various systems in the body, including the cardiovascular system. When a patient with Marfan syndrome is considering pregnancy, it is essential to assess their risk factors to ensure a safe pregnancy. In this scenario, the clinical finding that places the patient at the highest risk for mortality during pregnancy is an aortic root diameter of 47 mm.

Aortic root dilation is a common manifestation of Marfan syndrome and can lead to serious complications during pregnancy, such as aortic dissection or rupture. An aortic root diameter of 47 mm indicates significant dilation and poses a high risk for adverse events during pregnancy.