Congenital cardiovascular disease in Turner syndrome
1National Institute of Child Health and Human Development, National Institutes of Health-Developmental Endocrinology Branch, Bethesda, MD 20892, USA. bondyc@mail.nih.gov
Insights
Turner syndrome (TS), or monosomy X, is a genetic condition affecting females. Cardiovascular disease is a major concern, necessitating improved adult cardiological follow-up and risk factor identification for aortic dissection.
Area of Science:
- Genetics and Cardiovascular Medicine
Background:
- Turner syndrome (monosomy X) affects 1 in 2000 live born females.
- Short stature is a consistent feature, but congenital cardiovascular disease (CVD) affects 50% and is a leading cause of premature mortality.
- Adult cardiological follow-up for TS is insufficient, despite CVD being a critical aspect.
Purpose of the Study:
- To review the spectrum of cardiovascular defects in Turner syndrome.
- To identify risk factors for aortic dissection and rupture in TS patients.
- To discuss genetic pathways in Turner cardiovascular disease and review current guidelines.
Main Methods:
- Literature review focusing on cardiovascular aspects of Turner syndrome.
- Analysis of risk factors for aortic dissection and rupture.
- Discussion of genetic pathways and current diagnostic/treatment guidelines.
Main Results:
- Turner syndrome presents a wide range of cardiovascular defects.
- Specific risk factors for aortic dissection/rupture are highlighted.
- X-chromosome genetic pathways and premature coronary artery disease are implicated.
Conclusions:
- Improved adult cardiological care and monitoring are crucial for Turner syndrome patients.
- Understanding genetic factors and risk stratification can mitigate cardiovascular mortality.
- Current guidelines for TS diagnosis and treatment require review and implementation.
Abstract:
Turner syndrome (TS), or monosomy X, occurs in approximately 1/2000 live born females. Intelligence is normal and short stature is the most obvious and consistent feature of the syndrome. Congenital cardiovascular disease affects approximately 50% of individuals and is the major cause of premature mortality in adults. Unfortunately, this most important aspect of the syndrome has received little attention outside of pediatric medicine, and adult cardiological follow-up is seriously lacking. This review describes the spectrum of cardiovascular defects with particular attention to identifying risk factors for aortic dissection/rupture. X-chromosome genetic pathways implicated in Turner cardiovascular disease, including premature coronary artery disease, are discussed. Recent guidelines for diagnosis and treatment of girls and women with TS are reviewed.
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