Syphilitic Aortitis Presenting with Coronary Ostial Stenosis and Aortic Regurgitation.

Bilateral coronary ostial stenosis without additional coronary artery involvement is a rare presentation of syphilitic aortitis, with most cases being identified post-mortem. Herein is presented a case of bilateral coronary ostial stenosis and aortic valve insufficiency caused by syphilitic aortitis without aneurysmal dilatation of the aorta. The patient underwent aortic root replacement and coronary artery bypass grafting. The intraoperative macroscopic findings raised the suspicion of an aortitis that was later confirmed to syphilitic aortitis on histological examination. It is of note that syphilis can be a cause of bilateral ostial stenosis in young adults with no predisposition to atherosclerosis, especially if combined with aortic insufficiency resulting from an isolated leaflet dysfunction.

Doehle-Heller aortitis: speed of decision is what saves life.

A 48-year-old woman presented with severe acute heart failure of 7 days duration. Because of her rapidly worsening clinical condition, anatomical diagnosis of aortopulmonary fistula was made by urgent cardiac catheterization, and she successfully underwent immediate surgical closure. Retrospectively, the diagnosis of syphilitic aortitis complicated with aortopulmonary fistula was made by clinical profile, serology, and histopathology.

Syphilitic aortitis complicated by multiple aortic aneurysms: findings of multidetector CT.

We report a case of syphilitic aortitis complicated by multiple aortic aneurysms in a 50-year-old man with elevated rapid plasma reagin titer of 1:128 and positive Treponema pallidum particle agglutination test. 256-slice MDCT depicted two saccular aneurysms in the descending thoracic aorta with a markedly thick mural thrombus causing the trachea and esophagus to shift to the right. Thickening of the aortic wall was also noted. Stenting of the proximal descending thoracic aortic aneurysm and aorto-right common carotid artery bypass were performed. Operative findings revealed thickening of the descending thoracic aortic wall with a coarse luminal surface.

[Bilateral ostial coronary lesion in cardiovascular syphilis: case report]. / Lesão bilateral dos óstios coronários na sífilis cardiovascular: relato de caso.

Syphilis is an infectious disease occurring through a series of frequently overlapping stages. It can impair the cardiovascular and neurological system. In 30% of the non treated patients, syphilis develops its tertiary form. We report a case of a 46-year-old male patient admitted due to edema pulmonary and acute coronary syndrome with left bundle branch block, submitted to fibrinolytic therapy successfully. Coronary angiography showed a 90% ostial lesion of left main coronary artery and occlusion of the right coronary artery ostium. VDRL was titrated to 1/128. The patient was undergone to CABG and was discharged after treatment with crystalline penicillin.

Lesão bilateral dos óstios coronários na sífilis cardiovascular: relato de caso / Bilateral ostial coronary lesion in cardiovascular syphilis: case report

A sífilis é uma doença infecciosa que se desenvolve em estágios e pode acometer o sistema cardiovascular e neurológico. Em 30 por cento dos pacientes não tratados, a sífilis desenvolve sua forma terciária. Relatamos o caso de um homem de 46 anos, admitido por edema pulmonar agudo por cardiopatia isquêmica com bloqueio completo do ramo esquerdo, submetido a terapia fibrinolítica com sucesso. Angiografia coronária mostrou lesão ostial de 90 por cento na artéria coronária esquerda e oclusão do óstio da artéria coronária direita. Os títulos de VDRL foram de 1/128. O paciente foi submetido a revascularização do miocárdio e recebeu alta após tratamento antibiótico com penicilina cristalina.

Syphilis is an infectious disease occurring through a series of frequently overlapping stages. It can impair the cardiovascular and neurological system. In 30 percent of the non treated patients, syphilis develops your tertiary form. We report a case of a 46-year-old male patient admitted due to edema pulmonary and acute coronary syndrome with left bundle branch block, submitted to fibrinolytic therapy successfully. Coronary angiography showed a 90 percent ostial lesion of left main coronary artery and occlusion of the right coronary artery ostium. VDRL was titrated to 1/128. The patient was undergone to CABG and was discharged after treatment with crystalline penicillin.

[Syphilitic aortitis. Experience of an internal medicine unit]. / Les aortites syphilitiques. Expérience d'un service de médecine interne.

INTRODUCTION: Infectious aortitis remains a rare disease. It is characterized by an endarteritis of infectious origin generally followed by the development of a so called mycotic aneurysm. Those infectious aneurysms account for 0.5 to 1.3% of all aortic aneurysms. Of the infectious agents, Treponema pallidum has a particular place. Cardiovascular syphilitic infection was very common at the beginning of the XX(th) century with a prevalence of 6.9% of all autopsies. In 1950-1960, the prevalence had decreased to less than 1%. Since 1990, syphilis was considered as disappeared. EXEGESIS: we report syphilitic aortitis in four patients. Diagnosis, treatment, and prognosis are detailed. CONCLUSION: A syphilitic infection of the aorta should be looked for in every patient suffering from an inflammatory or infectious disease of aorta.

Aneurisma sifilítico da aorta / Aortic syphilitic aneurysm

Os autores relatam um caso de aneurisma sifilítico da aorta (ASA) que, após o advento da antibioticoterapia quando ministrada nos estádios iniciais da doença, é de pouca incidência. A presunção diagnóstica foi corroborada por aspectos clínico-epidemiológicos sugestivos, radiografia e tomografia computadorizada do tórax, sendo confirmado pelo anatomopatológico da peça cirúrgica.

The erythrocyte sedimentation rate in syphilis.

The erythrocyte sedimentation rate was studied in 520 men and 202 women with syphilis. It was raised in 66-6 per cent. of sero-negative primary cases, 80 per cent. of sero-positive cases, 100 per cent. of secondary cases, 80 per cent. of early latent cases, and 73-9 per cent. of late latent cases. It was also raised in sixteen out of seventeen cases of neurosyphilis and in all eleven cases of cardiovascular syphilis. It was concluded that the ESR had little place in the management of syphilis in general, but could be helpful in the post-treatment follow-up of late syphilis.