THE NATURAL HISTORY OF SYPHILITIC HEART DISEASE

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Abstract
The clinical features in 514 cases of syphilitic cardiovascular disease confirmed at autopsy are reviewed. Uncomplicated aortitis was found to be asymptomatic. There were 21 deaths between the ages of 20-30 years, 12 cases of auricular fibrillation and 9 of bacterial endocarditis. In half the cases of aortic valve insufficiency with coexisting arteriolo-nephrosclerosis, diastolic blood pressures of 80-100 mm. Hg were maintained. A striking tendency to rapid development of heart failure after the initial appearance of the aortic valve insufficiency was demonstrated. The avg. length of life after appearance of a diastolic murmur was 2 years, furnishing a helpful etiologic diagnostic sign in distinguishing between rheumatic and syphilitic valve disease. The "Austin Flint" murmur was demonstrated in many cases. Coronary ostial stenosis was equally present in males and females; half of all cases occurred in young adults.

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