syphilitic aneurysm formation

Last reviewed 01/2018

Aneurysms occur most commonly in the ascending aorta and with decreasing frequency in the arch and descending aorta.

The clinical features depend on the involvement of neighbouring organs:

• there may be pain - often sustained and boring in nature
• vertebrae, ribs and sternum may be eroded
• there may be visible pulsation in the neck with tracheal deviation
• the superior vena cava may become obstructed
• obstruction of the oesophagus may cause dysphagia
• compromise of the airway may cause stridor
• damage to the left recurrent laryngeal nerve may cause hoarseness

A syphilitic aneurysm may rupture into:

• left main bronchus
• left pulmonary artery
• left pleural space