[A case of ruptured left ventricular aneurysm due to syphilitic myocarditis]

This case involved a 20-year-old male who on May, 14, 1992, lost consciousness while working and went into a state of shock. He was taken to a hospital, where cardiac tamponade was diagnosed. He was later transferred to this hospital. Based on the results of echocardiography, coronary arteriography and left ventriculography, a ruptured ventricular aneurysm was diagnosed. The patient underwent emergency surgery. Serologic tests for syphilis performed at admission were definitely positive. Histopathological examination of the wall of the ventricular aneurysm disclosed fibrous myocarditis and peripheral coronary endarteritis accompanied by infiltration of plasma cells and lymphocytes. Immunohistological study revealed treponeme in the histiocytes of the aneurysmal wall. The diagnosis was a ruptured ventricular aneurysm caused by syphilitic myocarditis. Since the advent of penicillin therapy, cardiovascular syphilis, particularly syphilitic myocarditis, has become a rare disease. The chief interest of this case is that treponeme was detected in the lesion of myocarditis.