MRCEM Notes

Marfan's syndrome

Marfan's syndrome is an autosomal dominant connective tissue disorder. It is caused by a defect in the fibrillin-1 gene on chromosome 15 and affects around 1 in 3,000 people.

Features
  • tall stature with arm span to height ratio > 1.05
  • high-arched palate
  • arachnodactyly
  • pectus excavatum
  • pes planus
  • scoliosis of > 20 degrees
  • heart: dilation of the aortic sinuses (seen in 90%) which may lead to aortic aneurysm, aortic dissection, aortic regurgitation, mitral valve prolapse (75%),
  • lungs: repeated pneumothoraces
  • eyes: upwards lens dislocation (superotemporal ectopia lentis), blue sclera, myopia
  • dural ectasia (ballooning of the dural sac at the lumbosacral level)

The life expectancy of patients used to be around 40-50 years. With the advent of regular echocardiography monitoring and beta-blocker/ACE-inhibitor therapy this has improved significantly over recent years. Aortic dissection and other cardiovascular problems remain the leading cause of death however.
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