Which finding is a red flag for Marfan syndrome in athletes and raises concern during exertion?

• A. Aortic root dilation.
• B. Tall slender build.
• C. Arachnodactyly.
• D. Hypermobile joints.

Answer: (A)

During exertion, the biggest danger in Marfan syndrome is a dilated aortic root. The aorta’s wall is weakened in Marfan, so when blood pressure and the load on the aorta rise with exercise, the enlarged root is at higher risk of tearing or rupturing (dissection). That potential for life-threatening dissection is why aortic root dilation is the red flag in athletes.

The other features—tall, slender build; arachnodactyly (long, thin fingers); and hypermobile joints—are common Marfan traits and help raise suspicion, but they don’t in themselves indicate acute risk during exercise the way an enlarged aortic root does. Detecting and monitoring the dilation guides activity restrictions and medical management to reduce the risk of dissection.