AUTHOR=Wang Ru , Zhang Li , Xia Binfeng , Kong Min , Huang Huihui , Yin Xia 

TITLE=Cardiovascular syphilis: a rare case report and literature review of severe aortic regurgitation and bilateral coronary ostial stenosis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1444974

DOI=10.3389/fcvm.2025.1444974

ISSN=2297-055X

ABSTRACT=Due to the low incidence of cardiovascular involvement in syphilis, there are currently no established consensus or guidelines for managing such cases. The patient, with no coronary artery disease risk factors, presented with chest pain and heart failure (HF). Emergency coronary angiography revealed severe stenosis of the bilateral coronary ostia, with smooth intimal lining in the remaining coronary arteries. Echocardiography showed severe aortic regurgitation. Positive syphilis serology strongly suggested cardiovascular syphilis (CVS). The patient was transferred to cardiothoracic surgery for aortic valve replacement (AVR) and coronary artery bypass grafting (CABG), but died from acute HF despite resuscitation efforts.