TRENDS IN CARDIOVASCULAR SYPHILIS

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Abstract
Charts of 954 patients with cardiovascular syphilis were analyzed to determine trends in incidence, diagnosis, treatment and prognosis at the Los Angeles County Hospital during the years 1945 - 1954. In that period the incidence of cardiovascular syphilis decreased approximately 47%. Twenty-six and eight tenths per cent of the patients were found to have syphilitic aortitis; 49.5%, syphilitic aortic insufficiency; 9.3%, syphilitic aortic insufficiency associated with syphilitic aortic aneurysm; 14,0%, syphilitic aortic aneurysm. The most common complication was congestive heart failure, followed by hypertension and angina pectoris. Blood serologic reactions for syphilis were positive or repeatedly doubtful in 82% of all patients studied. Radiologic findings were normal in only 8.8% of 633 patients examined. Normal ecgs were obtained in less than 4% of patients examined. No ecg pattern pathognomonic of cardiovascular syphilis was noted. Penicillin was confirmed as the drug of choice for the treatment of cardiovascular syphilis; progression of cardiovascular lesions was halted (as evidenced by radiologic examination), and untoward reactions were less frequent than were reactions following adequate treatment with bismuth and/or arsenic compounds. Prognosis as to long-time survival was best in the younger age groups.