comparing rheumatic and syphilitic aortic regurgitation
Last reviewed 01/2018
The aortic regurgitation seen in cardiovascular syphilis and rheumatic heart disease are compared and contrasted below:
- angina:
- an earlier and more frequent feature of syphilitic aortic regurgitation (SAR) than rheumatic aortic regurgitation (RAR) because syphilitic aortitis may cause coronary ostial stenosis
- diastolic murmur:
- in SAR the dilated aorta associated with syphilitic aortitis may cause the murmur to be maximal to the right of the sternum
- in RAR the murmur is maximal at the left sternal edge
- the murmur in SAR is usually louder
- heart block - seen more commonly in SAR
- aortic stenosis:
- does not occur in syphilitic aortic valve disease
- atrial fibrillation:
- may complicate RAR and SAR
- atrial fibrillation complications RAR then mitral valve disease should be suspected
- serology:
- in SAR specific tests are usually positive, e.g. FTA-ABS
- syphilis screening tests, e.g. VRDL are negative in up to 70% of cases of syphilitic aortitis