Endocarditis and ascending aortic aneurysm with aortic valve insufficiency secondary to late syphilis: Case report

Venereal syphilis, caused by Treponema pallidum, is a major global health problem. Untreated latent syphilis can progress to tertiary syphilis, often leading to severe complications such as cardiac involvement, particularly syphilitic aortitis, which may manifest decades after the initial infection. We present a case of a 46-year-old woman who developed an ascending aortic aneurysm and severe aortic valve insufficiency due to late-stage syphilis. She presented with bilateral lower limb edema, intermittent chest pain, decreased functional capacity, and dyspnea, ultimately requiring hospitalization for cardiogenic shock. Diagnostic imaging revealed significant aortic valve damage and aneurysmal dilation of the ascending aorta, while serological tests confirmed tertiary cardiovascular syphilis. Surgical intervention involved the reconstruction of the ascending aorta and replacement of the aortic valve with a bioprosthetic valve. Histopathological analysis indicated chronic endocarditis. Postoperative management included intensive care support and antibiotic treatment. The patient demonstrated satisfactory recovery, with no further complications reported at the 3-month follow-up.