Syphilitic Bilateral Coronary Artery Ostial Stenosis Presenting as Acute Coronary Syndrome

Abstract

Syphilis is an infectious disease which occurs through a series of frequently overlapping stages. It can impair the cardiovascular and neurological systems. In approximately 30% of non-treated patients, syphilis develops its tertiary form. We report a case of a 41-year male patient admitted due to acute coronary syndrome presented as unstable angina. Coronary angiography showed a 100% ostial lesion of left main coronary artery and 90% occlusion of the right coronary artery ostium. Subsequent Computed Tomography Angiography (CTA) scan showed prominent thickening of the aortic wall. The Venereal Disease Research Laboratory (VDRL) test was titrated to 1/16. The patient was referred for coronary artery bypass graft (CABG). Key words: Syphilis, Acute Coronary Syndrome, unstable angina, Coronary Angiography, Left Main Coronary Artery, Right Coronary Artery, Coronary ostial stenosis, Computed Tomography Angiography.