Cardiovascular syphilis: a rare case report and literature review of severe aortic regurgitation and bilateral coronary ostial stenosis

Due to the low incidence of cardiovascular involvement in syphilis, there are currently no established consensus or guidelines for managing such cases. The patient, with no coronary artery disease risk factors, presented with chest pain and heart failure (HF). Emergency coronary angiography revealed...

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Main Authors: Ru Wang, Li Zhang, Binfeng Xia, Min Kong, Huihui Huang, Xia Yin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Cardiovascular Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1444974/full
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author Ru Wang
Li Zhang
Binfeng Xia
Min Kong
Huihui Huang
Xia Yin
author_facet Ru Wang
Li Zhang
Binfeng Xia
Min Kong
Huihui Huang
Xia Yin
author_sort Ru Wang
collection DOAJ
description Due to the low incidence of cardiovascular involvement in syphilis, there are currently no established consensus or guidelines for managing such cases. The patient, with no coronary artery disease risk factors, presented with chest pain and heart failure (HF). Emergency coronary angiography revealed severe stenosis of the bilateral coronary ostia, with smooth intimal lining in the remaining coronary arteries. Echocardiography showed severe aortic regurgitation. Positive syphilis serology strongly suggested cardiovascular syphilis (CVS). The patient was transferred to cardiothoracic surgery for aortic valve replacement (AVR) and coronary artery bypass grafting (CABG), but died from acute HF despite resuscitation efforts.
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publishDate 2025-08-01
publisher Frontiers Media S.A.
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series Frontiers in Cardiovascular Medicine
spelling doaj-art-8754e0397ef04581b93c83ce1041b19d2025-08-25T05:26:16ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-08-011210.3389/fcvm.2025.14449741444974Cardiovascular syphilis: a rare case report and literature review of severe aortic regurgitation and bilateral coronary ostial stenosisRu WangLi ZhangBinfeng XiaMin KongHuihui HuangXia YinDue to the low incidence of cardiovascular involvement in syphilis, there are currently no established consensus or guidelines for managing such cases. The patient, with no coronary artery disease risk factors, presented with chest pain and heart failure (HF). Emergency coronary angiography revealed severe stenosis of the bilateral coronary ostia, with smooth intimal lining in the remaining coronary arteries. Echocardiography showed severe aortic regurgitation. Positive syphilis serology strongly suggested cardiovascular syphilis (CVS). The patient was transferred to cardiothoracic surgery for aortic valve replacement (AVR) and coronary artery bypass grafting (CABG), but died from acute HF despite resuscitation efforts.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1444974/fullcardiovascular syphilisbilateral coronary ostial stenosissevere aortic regurgitationheart failuredifferential diagnosis
spellingShingle Ru Wang
Li Zhang
Binfeng Xia
Min Kong
Huihui Huang
Xia Yin
Cardiovascular syphilis: a rare case report and literature review of severe aortic regurgitation and bilateral coronary ostial stenosis
Frontiers in Cardiovascular Medicine
cardiovascular syphilis
bilateral coronary ostial stenosis
severe aortic regurgitation
heart failure
differential diagnosis
title Cardiovascular syphilis: a rare case report and literature review of severe aortic regurgitation and bilateral coronary ostial stenosis
title_full Cardiovascular syphilis: a rare case report and literature review of severe aortic regurgitation and bilateral coronary ostial stenosis
title_fullStr Cardiovascular syphilis: a rare case report and literature review of severe aortic regurgitation and bilateral coronary ostial stenosis
title_full_unstemmed Cardiovascular syphilis: a rare case report and literature review of severe aortic regurgitation and bilateral coronary ostial stenosis
title_short Cardiovascular syphilis: a rare case report and literature review of severe aortic regurgitation and bilateral coronary ostial stenosis
title_sort cardiovascular syphilis a rare case report and literature review of severe aortic regurgitation and bilateral coronary ostial stenosis
topic cardiovascular syphilis
bilateral coronary ostial stenosis
severe aortic regurgitation
heart failure
differential diagnosis
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1444974/full
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