SHM Converge Scientific Abstract ePoster Gallery-A 6'7" Clue: Delayed Suspicion of Marfan Syndrome in a Patient With Sepsis, Atrial Flutter, and Neck Stiffness

A 6'7" Clue: Delayed Suspicion of Marfan Syndrome in a Patient With Sepsis, Atrial Flutter, and Neck Stiffness

Pdf Summary

This case describes a 6’7” man with sepsis-like symptoms, atrial flutter, and neck stiffness whose underlying diagnosis was later recognized as previously undiagnosed Marfan syndrome. Although Marfan syndrome did not explain his initial fever and systemic inflammatory response, it did account for several other findings: mitral valve prolapse with moderate-to-severe mitral regurgitation, marked left atrial enlargement, and new-onset atrial flutter likely caused by structural atrial remodeling. His neck pain was also thought to possibly reflect cervical ligamentous laxity and degenerative changes associated with Marfan syndrome.<br /><br />The case highlights how Marfan syndrome can be missed when acute illness dominates the presentation. In this patient, the diagnosis was delayed until a broader evaluation connected his striking height and cardiovascular and musculoskeletal findings. His symptoms improved with rate control using diltiazem, and he was discharged in stable condition with outpatient cardiology and genetics follow-up. At one-month follow-up, both palpitations and neck pain had fully resolved.<br /><br />The key teaching point is that careful history and physical examination remain essential, especially in patients with unusual body habitus or unexplained cardiac findings. Recognizing Marfan syndrome matters because it can reveal important structural heart disease and guide surveillance for serious complications.

Asset Subtitle

Harrison Ngue

Meta Tag

Author List Harrison Ngue, Ryan E. Nelson, Timothy Long

Category Clinical Vignettes

Concept Marfan Syndrome

Concept Cardiac Complication

Concept Mitral Valve Prolapse

Concept Mitral Regurgitation

Concept Clinical Suspicion

Distinguished Non-Finalist

Presenter Organization Harvard Medical School, Harvard-Mit Division of Health Sciences and Technology

Presenting Author Harrison Ngue

Track Adult

Keywords

Marfan syndrome

sepsis-like symptoms

atrial flutter

mitral valve prolapse

mitral regurgitation

left atrial enlargement

neck stiffness

structural heart disease

cervical ligamentous laxity

cardiology follow-up

Marfan Syndrome

Cardiac Complication

Mitral Valve Prolapse

Mitral Regurgitation

Clinical Suspicion