Abstract
Cardiovascular syphilis occurs 15 to 30 years after infection.
Syphilitic aortitis is the most common manifestation and typically
involves the ascending aorta. Aneurysm formation is the least common
complication of aortitis; the majority of aneurysms are single and
usually saccular. We report the images of a 51-year-old man with a
history of chest pain that began one month before. An aneurysm of the
ascending aorta was documented. The nontreponemal and treponemal tests
were reactive. Other venereal diseases, as well as neurological
involvement, were discarded. The patient received treatment for
non-neurologic tertiary syphilis and surgical repair by the Bentall
procedure with re-implantation of the coronary arteries. Pathology
showed the aortic arterial layer displaying myxoid changes in the tunica
intima, as well as inflammatory infiltrate. The vasa vasorum
demonstrates inflammatory infiltration with lymphocytes and plasma
cells. The previous findings support the diagnosis of syphilitic
aortitis. The patient’s evolution was satisfactory with no current
cardiovascular symptoms.