Cardiovascular Disease in Syphilis

Abstract

his experience the most frequent serious and destructive lesion caused by syphilis is syphilitic aortitis with or without aortic insufficiency or aneurysm formation. It is an accepted fact that the bulb and lower portions of the ascending aorta are the centre of the most striking and characteristic patho- logical changes in syphilis of the vascular system (Stokes et al., 1946) which take the form of a supravalvular sclerosis (Martland, 1930). Involvement of the more distal part of the aortic arch is commoner in simple arteriosclerosis, while valvular involvement alone is more suggestive of rheumatic or other non-specific cardiac disease. Gordon et al. (1942) in a study of 360 cases of chronic syphilitic aortitis noted that atheromatous changes had taken place over the area affected by the syphilitic lesions, and suggest that chronic syphilitic lesions of the aorta predispose to the development of local arteriosclerosis. It would thus appear that, whether or not calcification is present in the aortic valve or in the more distal portions of the aortic arch, calcification of the first part of the ascending aorta is highly suggestive of an underlying or predisposing syphilitic lesion. Thus the radio- logical sign under discussion appears to have a sound patho- logical basis.