Related Experiment Video

Updated: Jun 1, 2025

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Left Main Coronary Artery Ostial Stenosis Caused by Syphilitic Aortitis Presenting With Syncope

Kanna Nakamura1, Kitae Kim1, Hiroshi Yamamoto2

  • 1Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.

JACC. Case Reports
|January 17, 2025
PubMed

Insights

Syphilitic aortitis can cause severe coronary artery stenosis, leading to syncope. Prompt diagnosis and surgical intervention, such as coronary artery bypass grafting, are crucial for successful treatment of this rare cardiovascular complication.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Neurology

Background:

  • Syphilis can lead to cardiovascular complications, including syphilitic aortitis.
  • Neurosyphilis is a serious manifestation affecting the central nervous system.

Observation:

  • A 51-year-old man presented with syncope after recent antibiotic therapy for syphilis.
  • Computed tomography revealed aortic wall thickening and severe left main coronary ostium stenosis.
  • Serologic and cerebrospinal fluid tests confirmed syphilitic aortitis and neurosyphilis.

Findings:

  • Coronary angiography showed severe stenosis of the left main coronary artery ostium.
  • Cardiac MRI revealed subendocardial late gadolinium enhancement in the left ventricle.
  • The patient underwent successful coronary artery bypass grafting with bilateral internal thoracic artery grafts.

Implications:

  • This case highlights the importance of considering syphilitic aortitis in patients with cardiovascular symptoms and a history of syphilis.
  • Early diagnosis and surgical management are vital for improving outcomes in syphilitic aortitis.
  • Coronary artery bypass grafting is an effective treatment for syphilitic coronary ostial stenosis.

Keywords:
computed tomographycoronary artery bypass graftingcoronary ostial stenosissyphilitic aortitis

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