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Which is the primary risk factor for ascending aortic aneurysm?

  1. Hypertension

  2. Atherosclerosis

  3. Marfan syndrome

  4. Hyperlipidemia

The correct answer is: Marfan syndrome

The primary risk factor for ascending aortic aneurysm is Marfan syndrome. This genetic connective tissue disorder significantly impacts the structure and integrity of the aorta. Individuals with Marfan syndrome have a defect in the fibrillin-1 protein, which leads to weakened connective tissue throughout the body, including the aortic wall. This diminished structural support makes the aorta more susceptible to dilation and aneurysm formation, particularly in the ascending aorta. While hypertension, atherosclerosis, and hyperlipidemia can contribute to cardiovascular disease and could be factors in aortic pathology, they do not specifically predispose individuals to ascending aortic aneurysms in the same direct manner as Marfan syndrome. Individuals with Marfan syndrome require regular monitoring for aortic enlargement due to this heightened risk, making it a critical consideration in clinical practice.