For a general discussion, and for links to other system-specific manifestations, please refer to the article on syphilis.
Syphilitic aortitis takes place during the stage of tertiary syphilis between 5 to 30 years after initiation of primary syphilis. This is normally due to infection of the aorta secondary to endarteritis obliterans of the vasa vasorum.
The aortic wall becomes progressively weakened due to chronic inflammation. This will subsequently lead to aneurysm (10%), coronary artery narrowing at its ostium (30%) and aortic valve insufficiency secondary to the involvement of the aortic valve.
- extensive thickening of aortic wall with periaortic inflammation
- asymmetrical aortic sinus involvement
- saccular aneurysms and heavily calcified ascending aorta
- "tree bark" intimal calcifications due to intimal wrinkling
- saccular asymmetric aortic aneurysm
- aortic root branches involvement
The aneurysm diameter is often not accurately measured by using angiography. This is normally due to intra-aneurysmal / mural thrombosis and calcification, layering of the contrast and magnification.
Treatment and prognosis
High-dose antibiotics and resection of enlarging aneurysm.
History and etymology
The term "lues" is an old name for syphilis, derived from Latin lues for "filth".
- 1. Paulo N, Cascarejo J, Vouga L. Syphilitic aneurysm of the ascending aorta. Interact Cardiovasc Thorac Surg. 2012;14 (2): 223-5. Interact Cardiovasc Thorac Surg (full text) - doi:10.1093/icvts/ivr067 - Free text at pubmed - Pubmed citation
- 2. Restrepo CS, Ocazionez D, Suri R et-al. Aortitis: imaging spectrum of the infectious and inflammatory conditions of the aorta. Radiographics. 2011;31 (2): 435-51. Radiographics (full text) - doi:10.1148/rg.312105069 - Pubmed citation
- 3. Madke BS, Agrawal NB, Vaideeswar P et-al. Luetic aortopathy: Revisited. Indian Journal of Sexually Transmitted Diseases and AIDS. 2010;31 (2): . Indian Journal of Sexually Transmitted Diseases and AIDS (full text) - doi:10.4103/0253-7184.75011 - Free text at pubmed - Pubmed citation
- 4. Szabados S, Varady E, GöBöLöS L. Luetic mycotic pseudoaneurysm of the aortic isthmus. Eur. Heart J. 2009;30 (16): 1963. Eur. Heart J. (full text) - doi:10.1093/eurheartj/ehp202 - Pubmed citation
- 5. MüLler AM, Hoffmann J, Weber A et-al. [Differential diagnosis of saccular aneurysms of the isthmus aortae: example of a penetrating atherosclerotic ulcer. Case-report and review of the literature]. Chirurg. 2004;75 (7): 713-8. Chirurg (full text) - doi:10.1007/s00104-003-0784-6 - Pubmed citation
- 6. Youatou P, Derluyn M, Roman A et-al. Ascending aorta syphilitic aneurysm presenting as a dystrophic disease. Acta Chir. Belg. 2004;104 (2): 231-3. Pubmed citation
- 7. Mickley V, Mohr W, Orend KH et-al. [Aneurysm of the descending thoracic aorta in tertiary syphilis]. VASA. 1995;24 (1): 72-6. Pubmed citation
- 8. Di Giacomo V, Meloni F, Leonori D et-al. [Syphilitic aneurysms of the abdominal aorta. Considerations on 2 cases]. G Ital Cardiol. 1981;10 (10): 1383-93. Pubmed citation
- 9. . Calcified luetic aneurysm of a sinus of Valsalva and ascending aorta. Ariz Med. 1976;33 (3): 203-4. Pubmed citation
- 10. Herrera H. Luetic aortitis in El Salvador. Pathol Microbiol (Basel). 1976;43 (2-O): 147-9. Pubmed citation
- acute aortic syndrome
- thoracic aortic aneurysm
- abdominal aortic aneurysm
- endovascular aneurysm repair (EVAR)
- reporting tips for aortic aneurysms
- aortic coarctation
- aortic pseudocoarctation
- cervical aortic arch
- interrupted aortic arch
- transposition of the great arteries
- variant anatomy of the aortic arch
- traumatic aortic injury