[Aneurysm of the ascending aorta in tertiary syphilis].
METHODS
A 58-year-old man was admitted after he was found to have a huge aneurysm of the thoracic aorta. 38 months previously he had first experienced subacute pain in the right thorax. After this the aneurysm gradually increased in size. On admission a pulsating mass, 20 cm in diameter, was obvious, having broken through the right ventral thoracic wall. It was causing venous inflow congestion in the upper part of the body. The patient's general condition was poor: he had marked orthopnoea.


METHODS
Serological tests for syphilis gave the following results: VDRL test, 1:32; FTA-ABS test reactive; TPHA test, 1:8000; treponema-specific IgM negative. Computed tomography with contrast-medium injection exactly defined site and extent of the aneurysm. It started at the aortic root and extended to the aortic arch. Third-degree aortic valvar regurgitation was demonstrated on echocardiography. Pulmonary function tests indicated severe restrictive ventilatory abnormality with clearly reduced respiratory reserve.


METHODS
The symptoms improved after 2 weeks on oral medication of captopril (25 mg/d), furosemide (80 mg/d), spironolactone (100 mg/d), codeine phosphate (90 mg/d) and thick paraffin (20 mg/d as needed). The patient declined further treatment. He died 8 weeks later at home.
Rühlmann
C
C
Medizinische Klinik und Poliklinik I, Zentrum für Radiologie der Universität Leipzig.
Wittig
K
K
Koksch
M
M
Müller
J
J
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000996:Antitussive Agents / Q000627:therapeutic use; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology; D002216:Captopril / Q000627:therapeutic use; D003061:Codeine / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004452:Echocardiography; D017809:Fatal Outcome; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010232:Paraffin / Q000627:therapeutic use; D013148:Spironolactone / Q000627:therapeutic use; D013587:Syphilis / Q000150:complications*; D013588:Syphilis Serodiagnosis; D014057:Tomography, X-Ray Computed
D000806:Angiotensin-Converting Enzyme Inhibitors; D000996:Antitussive Agents; D004232:Diuretics; D013148:Spironolactone; D005665:Furosemide; D010232:Paraffin; D002216:Captopril; D003061:Codeine