STDs Expert Forum
cardiovascular syphilis
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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cardiovascular syphilis

If you have cardiovascular syphilis is it possible not to exhibit any symptoms before heart failure? I know an aortic aneurysm is one of the symptoms, would a physical from your doctor be able to detect that particular symptom? or an ecg?
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Welcome to the forum.

I would be very surprised if cardiovascular syphilis is a reastlic possibility in you or anyone you know, especially if you are in the US or other industrialized country.  It is extremely rare these days -- in my 30+ years in the STD business, I have never seen a case.  Further, the identical problems -- aortic aneurysm, aortic valve insufficiency, and heart failure as a result -- are far more commonly due to other things than syphilis.  As a guess, for every 100,000 such cases I'll bet no more than one is due to syphilis.

With that as introduction the answer is yes:  whether due to syphilis or other causes, these abnormalities would usually be easily detected by a routine cardiac examination, chest Xray, ECG, or even routine blood pressure check before overt heart failure develops.  Not universally -- it is possible heart failure would appear as the first manifestation -- but unlikely.

If you or someone you know has heart disease of unknown cause, and if there has been a past diagnosis of syphilis or risks for it, having a syphilis blood test would make sense.  If you have specific reasons to suspect the person in question in fact has cardiovascular syphilis, I would be happy to comment further.

Regards--  HHH, MD
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University of Washington
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