Large coronary artery aneurysm in a syphilitic woman possibly related to syphilitic disease process.

Syphilis is known to affect the cardiovascular system in multiple ways but the occurrence of coronary artery aneurysm secondary to syphilitic disease process has never been previously described. We are presenting an interesting case report of a 54 year old female who presented to us with an evolved anterior wall myocardial infarction and coronary angiogram revealed a large thrombus containing aneurysm in the left anterior descending artery. The blood work up of the patient revealed that her VDRL test was positive which was confirmed by TPHA test. The patient decided for conservative medical management. The absence of evidence of atherosclerotic involvement of the same artery in the vicinity of the aneurysm and the other arteries creates a high likelihood of the aneurysm being related to the syphilitic disease process. Although the occurrence of atherosclerotic aneurysm cannot be ruled out completely, and only excision biopsy performed during surgical correction could have provided definitive association of the aneurysm with the syphilitic disease process but with the patient having opted for conservative management so this could not have been possible. Aneurysmal involvement of the coronary arteries due to syphilis has never been reported previously and could be a potentially life threatening complication of the disease and thereby merits a mention. [ABSTRACT FROM AUTHOR]