skip to main content

Turner Syndrome Aortic Surveillance — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCardiologyTurner Syndrome Aortic SurveillanceRACP Adult Medicine

A 55-year-old woman with Turner syndrome (45,X) has an ascending aortic diameter of 25 mm. She has a bicuspid aortic valve and no coarctation. Her body surface area is 1.5 m². The aortic size index (ASI = aortic diameter/BSA) is 16.7 mm/m². Guidelines suggest surgical intervention for ASI >25 mm/m² in Turner syndrome. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Continue surveillance — below ASI threshold

Turner syndrome patients have smaller body habitus — absolute aortic diameters underestimate aortic disease severity. ASI (aortic diameter indexed to BSA) is used instead. ASI >25 mm/m² is the suggested threshold for surgical intervention in Turner syndrome (equivalent to ~40-42 mm in a normal-sized adult). This patient's ASI of 16.7 mm/m² is below threshold — continue surveillance with annual echocardiography or MRI (preferred — also assesses for coarctation, bicuspid valve, and aortic arch anomalies). Pregnancy counselling is essential (aortic dissection risk).

Reference: ESC – 2024 – ACHD/Aortic Disease; Turner Syndrome Consensus 2024