Jasper Pablo
Philippine Heart Center, Philippines
Title: A rare case of syphilitic aortic aneurysm in the era of modern antibiotics
Biography
Biography: Jasper Pablo
Abstract
INTRODUCTION: In this age of medicine, most abdominal aortic aneurysms are of atherosclerotic in origin. Cardiovascular syphilis is a tertiary form of syphilis occurring in 10% of infected patients. It can affect the heart, great vessels and medium-sized arteries. Aortic involvement can present as uncomplicated aortitis, coronary ostial stenosis, aortic regurgitation, and aortic aneurysm. If left untreated, the mortality rate at 1 year can reach 80% due to the high rate of rupture of these aneurysms.
CASE: A 65-year old male, who came in due to chest pain. CT aortogram revealed a fusiform infrarenal aneurysm. Coronary angiogram was done which revealed 3-vessel coronary artery disease. He was tested positive for syphilis and was treated with Penicillin. A dilemma sets in if CABG and open repair of the infrarenal aneurysm is possible. A Thallium scan showed no inducible ischemia, hence, CABG was postponed. An open repair via retroperitoneal approach was done. Histopathologic examination of the aneurysm was consistent with syphilitic aneurysm. He was discharged apparently well until his most recent follow-up.
CONCLUSION: Tertiary syphilis, though a rare disease in this age of antibiotics, is a re-emerging cause of aneurysm and should be considered in patients with risk factors.