Syphilitic Aortitis Presenting with Coronary Ostial Stenosis and Aortic Regurgitation
Jadeed, R.; Paarmann, R.; Harringer, W.; El-Essawi, A.
Journal of Heart Valve Disease 25(1): 18-20
2016
ISSN/ISBN: 0966-8519 PMID: 27989079 Document Number: 690066
Bilateral coronary ostial stenosis without additional coronary artery involvement is a rare presentation of syphilitic aortitis, with most cases being identified post-mortem. Herein is presented a case of bilateral coronary ostial stenosis and aortic valve insufficiency caused by syphilitic aortitis without aneurysmal dilatation of the aorta. The patient underwent aortic root replacement and coronary artery bypass grafting. The intraoperative macroscopic findings raised the suspicion of an aortitis that was later confirmed to syphilitic aortitis on histological examination. It is of note that syphilis can be a cause of bilateral ostial stenosis in young adults with no predisposition to atherosclerosis, especially if combined with aortic insufficiency resulting from an isolated leaflet dysfunction.