Marfan syndrome is a genetic condition in which the proteins that make up the connective tissue that supports the heart, blood vessels and other vital organs is weakened. Most people with this condition have heart and blood vessel problems, often resulting in aortic aneurysm or valve dysfunction. Patients with Marfan syndrome have tall, thin frames, long legs, fingers and hands and may have problems with vision.
Marfan syndrome is caused by a mutation in the gene that controls how the body makes fibrillin-1, which is a protein that helps make up the connective tissue in the body. The mutation of this gene causes the body to produce more of a growth protein than fibrillin-1 creating weaker connective tissue that supports the heart, blood vessels and vital organs. The mutated gene is most commonly passed from a parent to child, but research has found that in about 25% of cases the new mutation occurs spontaneously.
Patient will have optimal cardiac output with adequate tissue perfusion. Patient will remain free from injury.
Get a baseline of data, note retractions or protrusion of sternum.
Get a baseline and monitor for elevated BP and heart rate that may indicate aortic injury or damage.
Listen for murmurs, leaky valves and abnormal breath sounds to determine progression of condition.
Monitor for signs of cardiac involvement, disease progression and determine cardiac function.
Patients often have extreme nearsightedness. Assess for degree of vision impairment and make recommendations for ophthalmologist.
Monitor for bone and joint deformities or malformations and monitor for spine curvature (scoliosis) to determine if braces, splints or other appliances are necessary.
Assess and monitor flexibility and range of motion as exercises are important for maintaining strength and mobility.
Patients may have fatigue or an intolerance to activity due to medications or cardiac involvement of the condition. Provide periods of rest to promote normalized blood pressure and prevent injury.
Medications are given to reduce the blood pressure and relieve the force of pressure on the aorta. The first-line medication is a beta blocker, but calcium channel blockers or angiotensin receptor blockers may be used in patients who are unable to tolerate beta blockers.
Surgery may be required to stabilize or correct aorta or valve issues. Other surgeries may be to repair or treat sternum problems from retraction or protrusion or for eye surgeries to repair retina or lens displacement.
Provide appropriate care and education before and after surgery as required.
Especially in the adolescent and teen years, patients are often self-conscious about appearance.
Help them to find beauty in themselves and offer information about resources and peer groups to build confidence and promote self-esteem.
For more information, visit www.nrsng.com/cornell
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