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How can tertiary syphilis affect the aorta and heart valves?
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syphilis
Scanning electron micrograph of Treponema pallidum, the spirochete bacterium that is the causative agent of syphilis.
In tertiary syphilis, the spirochete Treponema pallidum can cause significant damage to the cardiovascular system, specifically targeting the aorta and the aortic valve.12
The disease process involves the destruction of the aorta's elastic tissue, which leads to several severe complications:
- Aortic Insufficiency: Degeneration of the aortic valves can result in severe aortic insufficiency, causing the heart to enlarge and potentially leading to heart failure.12
- Aneurysms: The loss of elasticity and subsequent dilation of the aortic wall can cause the formation of aneurysms. These may grow large, interfere with blood flow, and potentially rupture, which can be fatal.12
- Coronary Impairment: The infection often affects the base of the aorta, where it can obstruct the openings to the coronary vessels. This impairs coronary circulation, leading to angina pectoris and, rarely, myocardial infarction.1
While these cardiovascular complications were common in the past, they are now much less frequent due to the availability of effective early treatment with penicillin.1