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Syphilitic aneurysm formation

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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

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