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Impending Aortic Rupture in a Patient with Syphilitic Aortitis
Mioara Cocora1, Dan Nechifor1, Mihai-Andrei Lazar2
1Department of Cardiovascular Surgery, Institute of Cardiovascular Diseases, Timisoara, Romania.
Vascular Health and Risk Management
|June 3, 2021
Summary
Aortic aneurysm and regurgitation in a 48-year-old man were treated with emergency surgery. Syphilitic aortitis was diagnosed postoperatively, highlighting the importance of serologic testing for this cardiovascular condition.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Surgery
Background:
- Syphilitic aortitis is a rare but serious complication of untreated syphilis.
- It can lead to aortic aneurysm, regurgitation, and dissection, mimicking other cardiovascular emergencies.
Observation:
- A 48-year-old man presented with atrial fibrillation, rapid heart rate, and chest pain.
- Imaging revealed a giant aortic aneurysm with severe aortic regurgitation and pericardial fluid, but no aortic dissection.
Findings:
- Emergency surgery (Bentall procedure) was performed due to suspected aortic rupture.
- Postoperative examination of the aortic wall showed a 'tree bark' appearance, suggesting syphilitic aortitis.
- Diagnosis was confirmed by serologic testing and histopathology.
Implications:
- This case underscores the importance of considering syphilitic aortitis in the differential diagnosis of aortic aneurysms, especially in patients with suggestive clinical or pathological findings.
- Early diagnosis and appropriate treatment are crucial for managing syphilitic aortitis and preventing life-threatening complications.
- Multidisciplinary management involving cardiology, infectious diseases, and vascular surgery is essential for optimal patient outcomes.
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