Incidentally Detected Ascending Thoracic Aortic Aneurysm and Bicuspid Aortic Valve

To the Editor A recent JAMA Clinical Challenge reported the case of a 25-year-old female with incidental thoracic aortic aneurysm and bicuspid aortic valve (BAV). I am concerned that this article missed an important teaching point related to diagnostic workflow and did not identify the cause(s) of the thoracic aortic aneurysm and BAV, needed for diagnosis, treatment, and surveillance of this condition. In this young adult female, the family history of her father having an ascending aorta dissection repaired at age 60 years indicates an autosomal dominant inheritance with a 50% risk for first-degree relatives (children, siblings, and parents).