Syphilitic aortitis: Difference between revisions
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'''''Synonyms and Keywords:''''' SA; Heller-Döhle syndrome | |||
==Overview== | ==Overview== | ||
A pathological state of the aorta associated with the tertiary stage of [[syphilis]] | A pathological state of the aorta associated with the [[Syphilis pathophysiology#Tertiary syphilis|tertiary stage]] of [[syphilis|syphilis infection]]. Syphilitic aortitis begins as inflammation of the adventia, including the vessels that supply the aorta itself with blood, the [[vasa vasorum]]. As the disease progression worsens, the vasa vasorum demonstrate hyperplastic thickening of their walls that restricts blood flow and causes [[ischemia]] of the outer 2/3's of the aortic wall. Starved for [[oxygen]] and nutrients, elastic fibers become patchy and smooth muscle cells necrose. The wall weakens and scars. If the disease progresses, syphilitic [[aoritis]] may lead to an [[aortic aneurysm]]. | ||
==Pathophysiology== | |||
Inflammatory involvement of [[Syphilis pathophysiology#Tertiary syphilis|tertiary syphilis]] begins at the adventitia of the [[aortic arch]] which progressively causes [[Obliterating endarteritis|obliterative endarteritis]] of the vaso vasorum. This then causes narrowing of the lumen of the vaso vasorum, causing [[ischemia|ischemic injury]] of the medial aortic arch and then finally loss of elastic support and dilation of the vessel. [[Aortic dissection|Dissection of the aortic arch]] is rare due to medial scarring. | |||
==Diagnosis== | |||
=====Chest X-ray===== | |||
*[[Aortic dilatation]] | |||
*Linear calcification of the ascending aorta | |||
=====Angiography===== | |||
*Helps to distinguish syphilitic aortitis from [[aortic aneurysm|abdominal aortic aneurysm]] | |||
==Related chapters== | ==Related chapters== | ||
Revision as of 15:08, 21 February 2012
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Syphilitic aortitis On the Web | |
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American Roentgen Ray Society Images of Syphilitic aortitis | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Synonyms and Keywords: SA; Heller-Döhle syndrome
Overview
A pathological state of the aorta associated with the tertiary stage of syphilis infection. Syphilitic aortitis begins as inflammation of the adventia, including the vessels that supply the aorta itself with blood, the vasa vasorum. As the disease progression worsens, the vasa vasorum demonstrate hyperplastic thickening of their walls that restricts blood flow and causes ischemia of the outer 2/3's of the aortic wall. Starved for oxygen and nutrients, elastic fibers become patchy and smooth muscle cells necrose. The wall weakens and scars. If the disease progresses, syphilitic aoritis may lead to an aortic aneurysm.
Pathophysiology
Inflammatory involvement of tertiary syphilis begins at the adventitia of the aortic arch which progressively causes obliterative endarteritis of the vaso vasorum. This then causes narrowing of the lumen of the vaso vasorum, causing ischemic injury of the medial aortic arch and then finally loss of elastic support and dilation of the vessel. Dissection of the aortic arch is rare due to medial scarring.
Diagnosis
Chest X-ray
- Aortic dilatation
- Linear calcification of the ascending aorta
Angiography
- Helps to distinguish syphilitic aortitis from abdominal aortic aneurysm