Dilation of the aorta in patient with aortic valve prosthesis and past history of neurosyphilis

An observation of a patient hospitalized for sigmoid diverticulitis, complicated by abscess formation and requiring a non-trivial study of cardiological comorbidity, the etiology of which was not mentioned in available medical documentation, has been presented. Retrospective analysis of anamnestic, laboratory and instrumental data showed that the aortic valve disease for which patient had previously undergone prosthesis with mechanical valve, and dilation of the aorta were the result of prior visceral syphilis. Neurological symptoms that to the greatest extent reduced the patient’s quality of life were caused rather by the effects of intracranial hemorrhages developed in association with warfarin and neurosurgical treatment than by consequences of treated neurosyphilis. It was not possible to assess the aortic wall condition with magnetic resonance imaging due to the presence of a mechanical valve of the heart. There were no indications for surgical treatment of aortic aneurysm, conservative therapy of arterial hypertension and hyperlipidemia was continued, anticoagulation therapy was optimized. The patient was discharged to be followed up by a venereologist at the place of residence after successful treatment of the abdominal abscess. The given case demonstrates the difficulties of diagnosing cardiovascular syphilis in real-life clinical practice, which requires interdisciplinary interaction, and actualize the need to restore the lost in recent years awareness of doctors with regard to visceral syphilis. The article also briefly discusses current trends in the epidemiology of syphilis and its cardiovascular manifestations.