Given clinical presentation is suggestive of Marfan syndrome. Features of Marfan syndrome. Skeletal Cardiovascular Others Long limbs and tall stature Upper segment: lower segment <2 SD Arachnodactyly- long, slender fingers and hands Pectus excavatum/pectus carinatum Scoliosis MVP Dilatation of aoic root Aoic regurgitation Aoic aneurysm Ectopia lentis Spontaneous pneumothorax Inguinal hernia Diagnosis is based on the revised Ghent criteria- major and minor criteria. 4 major criteria Ectopia lentis Dilatation of ascending aoa with/without dissection A blood relative who meets the same criteria With/without DNA diagnosis Fuher workup with echocardiogram and slit-lamp examination will be required in this patient. Sudden death of the patient's father is likely to represent an aoic aneurysm rupture. Because this patient has several clinical features and a murmur concerning for Aoic regurgitation, an echocardiogram would not be required before removing him from fuher strenuous physical activity.