Key result
Timing aortic root interventions in athletes requires balancing sport demands, root growth, symptoms, and goals.
Why the study?
Does continued participation in dressage accelerate aortic root dilation in an athlete with familial TAAD?
Case Report (n=1)
Does continued participation in dressage accelerate aortic root dilation in an athlete with familial TAAD?
Dressage is unlikely to contribute to accelerated aortic root progression in genetically predisposed athletes, highlighting the importance of sport-specific shared decision-making.
Answers are grounded in this paper and cite their sources.
May inform individualized intervention timing in athletes with aortic dilation; hypothesis-generating for sport-specific thresholds.
BACKGROUND: Familial thoracic aortic aneurysm and dissection is a genetic condition frequently presenting without syndromic features or early symptoms, and it often warrants restrictive sports advice. CASE SUMMARY: A masters dressage rider presented with palpitations and atypical thoracic discomfort. Cardiac magnetic imaging revealed an aortic root of 47 mm. Genetic testing confirmed a pathogenic class V LTBP3 variant consistent with familial thoracic aortic aneurysm and dissection. Although prophylactic surgery was considered given subsequent growth to 49 mm, continued surveillance was chosen after shared decision-making, as the aortic root diameter did not reach the surgical threshold and remained stable during 5 years of follow-up. The patient competed in multiple international competitions, without evidence of accelerated root growth. DISCUSSION: Dressage is unlikely to contribute to aortic root progression in genetically predisposed athletes. TAKE-HOME MESSAGE: In athletes, decisions about timing of intervention should consider sport-specific hemodynamic demands and force distribution, aortic dimensions and growth, symptom burden, and athlete ambitions and goals.
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Hri et al. (2026) conducted a case report in Familial thoracic aortic aneurysm and dissection (n=1). Continued surveillance and dressage competition was evaluated on Aortic root growth. Continued surveillance and dressage competition in a masters athlete with familial TAAD resulted in stable aortic root dimensions without accelerated growth over 5 years of follow-up.
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