A 58-year-old man with untreated syphilis presents with substernal chest discomfort and progressive hoarseness. Vital signs show BP 165/92 mmHg, HR 88 bpm, RR 16, temp 37°C, SpO2 98%. Chest radiograph reveals marked dilation of the ascending thoracic aorta with aortic regurgitation on echocardiography. RPR is elevated; FTA-ABS is positive. Coronary angiography shows no significant stenosis. Which pathologic process most likely caused this aortic lesion?
- A)Mural thrombosis of the abdominal aorta due to smoking
- B)Immune complex deposition in postcapillary venules
- C)Atherosclerotic plaque rupture in the infrarenal aorta
- D)Myxomatous degeneration of the valve annulus
- E)Obliterative endarteritis of the vasa vasorumGABARITO
Explicação
Tertiary syphilis can cause thoracic aortic aneurysm because inflammation of the vasa vasorum produces ischemic injury to the aortic media. This obliterative endarteritis weakens the wall and may lead to root dilation and aortic regurgitation. Hoarseness can r... Ver explicação completa e trilha adaptativa →