Syphilitic aortitis

Syphilitic aortitis

A pathological state of the aorta associated with the tertiary stage of syphilis infection. SA begins as inflammation of the adventia, including the vessels that supply the aorta itself with blood, the vasa vasorum. As it worsens, the vasa vasorum show 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 leads to an aortic aneurysm.

Overview:Inflammatory involvement of tertiary syphillis begins at the adventitia of the aortic arch which progessively causes obliterative endarteritis of the vaso vasorum. This then causes narrowing of the lumen of the vaso vasorum causing ischemic injury of the media of the 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.

References

[http://www.nlm.nih.gov/medlineplus/ency/article/000729.htm NIH]


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