CHRONIC DISSECTING ANEURYSM OF THE AORTA, SIMULATING SYPHILITIC CARDIOVASCULAR DISEASE; NOTES ON THE ASSOCIATED AORTIC MURMURS

Abstract

Occasionally dissecting aortic aneurysm of the chronic type closely simulates syphilitic cardiovascular disease; the signs of aortic valvular regurgitation and of aortitis are preserved. Progressive congestive heart failure may continue for many mos. or even yrs. There is often no pain or history of a painful seizure. Life is terminated by heart failure or occasionally by a long delayed secondary aortic rupture. The aortic valvular leakage is directly dependent upon the proximity of the dissection to the valvular ring (the supravalvular portion). In 6 patients of the above type notable features were: the persistently negative serologic tests for syphilis; the usually marked and often enormous enlargement of the left ventricle with the constant dilatation of the ascending arch of the aorta; and the relatively high incidence of hemoptysis.