Syphilitic Aortitis Presenting With De-Novo Aortic Thrombus and Acute Myocardial Infarction.

BACKGROUND

Syphilitic aortitis, caused by Treponema pallidum, is a known complication of tertiary or latent syphilis.

CASE SUMMARY: We present a case of syphilitic aortitis in a patient who presented with acute inferior ST-segment elevation myocardial infarction and was detected to have a large, mobile aortic thrombus on cardiac magnetic resonance imaging and confirmed with coronary computed tomography angiogram. After multidisciplinary discussion, the patient underwent urgent definitive surgical intervention.

DISCUSSION: With syphilis cases surging, clinicians must maintain a high index of suspicion for syphilitic aortitis with atypical clinical presentations. Multimodality cardiovascular imaging is imperative to establish a diagnosis, and surgical intervention may be required to treat this rare disease.

TAKE-HOME MESSAGE: Awareness and timely intervention are essential to address this morbid, re-emerging public health challenge.