Syphilitic Aortic Incompetence

Heart Disease in Old Age

“…According to some, it is almost invariably of rheumatic origin (Karsner and Koletsky, 1947) (Levine, Stein, Gordon and Mitchell, 1951); incomplete aortic rupture (Peery, 1942), in which a tear in the aortic intima just above the aortic valve allows the adjacent cusp to prolapse into the left ventricle in diastole; giant-cell (temporal) arteritis; and aortitis in ankylosing spondylitis (Clark, Kulka, and Syphilitic heart disease is now comparatively uncommon at any age, but in recent series about onethird of cases have been over 60 years of age (Macfarlane, Swan, and Irvine, 1956; Leonard and Smith, 1957). It is commoner in old men than in old women, and rare over the age of 80 (Bedford and Caird,I960).…”

“…There are four common causes: rheumatic endocarditis and calcareous disease of the aortic valve, already discussed; syphilitic aortitis; and 'isolated nonsyphilitic aortic incompetence' (Bedford and Caird, I960), a term preferable to 'functional' or 'arteriosclerotic' aortic incompetence. Syphilitic Aortic Incompetence Syphilitic heart disease is now comparatively uncommon at any age, but in recent series about onethird of cases have been over 60 years of age (Macfarlane, Swan, and Irvine, 1956;Leonard and Smith, 1957). It is commoner in old men than in old women, and rare over the age of 80 (Bedford and Caird,I960).…”

“…A collapsing pulse, high pulse pressure, and considerable left ventricular enlargement are evidence of severe aortic incompetence in many cases. An aortic ejection murmur is the rule, but a basal systolic thrill is uncommon (Leonard and Smith, 1957). The aortic second sound is often loud and ringing, and the aortic diastolic murmur long and widely heard over the praecordium.…”