Cardiovascular complications of tertiary syphilis: rupture of the aneurysm of the descending thoracic aorta, followed by the formation of an aortoesophageal fistula

Relevance. 30% patients who infected syphilis during the long time have got complications characterized as tertiary syphilis. Vascular complications often manifest after 15–30 years. An aortic aneurysm is one of the rare cardiovascular syphilis manifestation. Due to the fact that it is a rare complication, timely diagnosis and the correct treatment choice for such patients are important.

The aim of the study. To analyze the diagnosis’ features and surgical treatment tactics for patients with syphilitic aortic aneurysm. Materials and methods. This paper describes a clinical case of a patient with ruptured syphilitic descending thoracic aortic aneurysm and signs of aortoesophageal fistula formation. The data analysis was performed retrospectively.

Results. Patient P. was admitted to the clinic in April 2024. For two weeks he had been complaining of cough and epigastric pain. The examination revealed ruptured thoracic aortic aneurysm (I71.1). The patient underwent left carotid subclavian bypass surgery and thoracic endovascular aortic aneurysm repair. Six months later according to endoscopic examinations and computer tomography an aortoesophageal fistula was established.

Conclusion. Identification of patients with syphilitic vascular complications is difficult. A syphilitic aortic aneurysm feature is its long-term asymptomatic course, which makes it difficult to early detection and treatment.

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