Aneurysm and dissection of thoracic aorta secondary to syphilitic aortitis

Abstract

Introduction: Cardiovascular syphilis varies in its presentation at the cardiac level and occurs as aortitis, aortic aneurysm, aortic insufficiency. It is released between 10 and 30 years after the initial infection, in patients who were not treated and its diagnosis is rare today, due to the wide range of antibiotics available.

Objectives: To report a case of aortic aneurysm plus aortic dissection secondary to syphilitic aortitis.

Materials and methods:

The clinical and paraclinical data of the patient were collected with prior informed consent, which were based on the physical clinical history, performing a retrospective, observational and qualitative analysis of the same, during a period of time of 2 weeks.

Results: Female patient, 83 years old, with arterial hypertension, hypothyroidism, syphilis, aortic aneurysm, paroxysmal atrial fibrillation, was admitted to the emergency service due to unstable angina accompanied by diaphoresis and palpitations; vital signs, BP: 90/60, HR: 105 bpm, RR: 25 bpm, SATO2%: 92%, audible arrhythmic heart, holodiastolic murmur II / VI in aortic focus, ulcerated dermal lesion on right foot, 10 cm in diameter, VDRL test reactive. EKG in atrial fibrillation. Contrast chest CT showed an acute Bakey III thoracic aortic dissection. Derived for endovascular treatment.

Discussion and conclusions: syphilitic aortitis is the most common manifestation of cardiovascular syphilis and compromises the ascending aorta by 50%. Uncomplicated aortitis is asymptomatic, aneurysm rupture and heart failure are the causes of death associated with cardiovascular syphilis