Syphilitic aortitis

Syphilitic aortitis is inflammation of the aorta associated with the tertiary stage of syphilis infection. It begins as inflammation of the outermost layer of the vessel wall, including the small vessels that supply the aorta itself, the vasa vasorum. As the disease worsens these small vessels thicken and restrict blood flow, so the outer part of the aortic wall is starved of oxygen and nutrients, its elastic fibers become patchy and its smooth muscle cells die. If it progresses it leads to an aortic aneurysm, although tertiary syphilis is overall a rare cause of aortic aneurysm. The infection often causes no symptoms until an aneurysm develops from the widening of the aorta, and it is often found at a routine checkup of the heart and aorta. Other signs of tertiary syphilis, such as gummas and neurosyphilis, can also appear, and chest pain or shortness of breath can occur in rare cases when the aorta and heart valve are damaged. Intravenous penicillin has been the primary treatment since the 1940s, with surgical repair added when there is an aneurysm. The condition became rare in the developed world after penicillin treatment arrived following World War II. This entry records what the source states and is not medical advice.