ABSTRACT
A 27-year-old patient with tertiary syphilis, manifested as myocardial ischemia, presenting unstable angina, secondary to left coronary trunk occlusion. The diagnosis was confirmed by the serological findings and the pathological assessment of the aorta fragment.
Subject(s)
Coronary Artery Disease/pathology , Syphilis, Cardiovascular/pathology , Adult , Aorta, Thoracic/pathology , Humans , MaleABSTRACT
Paciente de 27 anos, portador de sífilis terciária, manifestando isquemia miocárdica, com angina instável, secundária à oclusão do tronco da coronária esquerda. O diagnóstico foi confirmado pelos achados da sorologia e da patologia do fragmento da aorta.
A 27-year-old patient with tertiary syphilis, manifested as myocardial ischemia, presenting unstable angina, secondary to left coronary trunk occlusion. The diagnosis was confirmed by the serological findings and the pathological assessment of the aorta fragment.
Paciente de 27 años, portador de sífilis terciaria, manifestando isquemia miocárdica, con angina inestable, secundaria a la oclusión del tronco de la coronaria izquierda. El diagnóstico fue confirmado por los resultados de la serología y de la patología del fragmento de la aorta.
Subject(s)
Adult , Humans , Male , Coronary Artery Disease/pathology , Syphilis, Cardiovascular/pathology , Aorta, Thoracic/pathologyABSTRACT
Cardiovascular tertiary syphilis may lead to aortitis, aortic aneurism, coronary stenosis, aortic insufficiency and, rarely, to myocarditis. The physician must be familiar with the clinical presentations of this process, including the asymptomatic variety and must be able to have an organized plan for the diagnosis and evaluation to establish or exclude the presence of cardiovascular pathology and the differential diagnosis with other entities. Once the etiologic and topographic diagnosis is established, the patient should be treated with penicillin, doxicycline and other antibiotics, and the consequences of the disorder, both actual and potential, should be considered before deciding weather to recommend surgical intervention. Although late syphilis can be prevented by appropriate therapy of early syphilis, this is a cardiovascular disease that most likely will continue to be diagnosed lately. Understanding of the pathology and pathophysiology of the disease, is most important for its prompt recognition and subsequent management. This paper reviews the natural history, diagnosis and therapy of cardiovascular syphilis.
Subject(s)
Adult , Female , Humans , Male , Syphilis, Cardiovascular , Administration, Oral , Age Factors , Anti-Bacterial Agents , Anti-Bacterial Agents , Diagnosis, Differential , Doxycycline , Doxycycline , Injections, Intramuscular , Magnetic Resonance Imaging , Myocardium/pathology , Phonocardiography , Prevalence , Penicillin G Benzathine , Penicillin G Benzathine , Radiography, Thoracic , Sex Factors , Syphilis Serodiagnosis , Syphilis, Cardiovascular , Syphilis, Cardiovascular , Syphilis, Cardiovascular , Syphilis, Cardiovascular/pathology , Syphilis, Cardiovascular , Syphilis, Cardiovascular , Time FactorsABSTRACT
Cardiovascular tertiary syphilis may lead to aortitis, aortic aneurism, coronary stenosis, aortic insufficiency and, rarely, to myocarditis. The physician must be familiar with the clinical presentations of this process, including the asymptomatic variety and must be able to have an organized plan for the diagnosis and evaluation to establish or exclude the presence of cardiovascular pathology and the differential diagnosis with other entities. Once the etiologic and topographic diagnosis is established, the patient should be treated with penicillin, doxicycline and other antibiotics, and the consequences of the disorder, both actual and potential, should be considered before deciding weather to recommend surgical intervention. Although late syphilis can be prevented by appropriate therapy of early syphilis, this is a cardiovascular disease that most likely will continue to be diagnosed lately. Understanding of the pathology and pathophysiology of the disease, is most important for its prompt recognition and subsequent management. This paper reviews the natural history, diagnosis and therapy of cardiovascular syphilis.
Subject(s)
Syphilis, Cardiovascular , Administration, Oral , Adult , Age Factors , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Doxycycline/administration & dosage , Doxycycline/therapeutic use , Female , Humans , Injections, Intramuscular , Magnetic Resonance Imaging , Male , Myocardium/pathology , Penicillin G Benzathine/administration & dosage , Penicillin G Benzathine/therapeutic use , Phonocardiography , Prevalence , Radiography, Thoracic , Sex Factors , Syphilis Serodiagnosis , Syphilis, Cardiovascular/diagnosis , Syphilis, Cardiovascular/diagnostic imaging , Syphilis, Cardiovascular/drug therapy , Syphilis, Cardiovascular/epidemiology , Syphilis, Cardiovascular/pathology , Syphilis, Cardiovascular/surgery , Time FactorsABSTRACT
A case of syphilitic aortitis, complicated by bilateral coronary ostial stenosis, in a 40-year-old man is described. Treatment included coronary artery bypass grafting and a drug regimen of penicillin. At 3-month follow-up, an exercise stress test revealed no signs of ischemia.