Syphilitic cardiovascular disease [clinical manifestations -

[] According to clinical manifestations of cardiovascular lesions and their characteristics, clinical can be divided into the following five categories : 1. Simple syphilitic aortic Yan (syphiliticaortitis) generally symptomless. Occasionally minor chest discomfort, it is difficult to clinical early detection. Visibility investigation aortic valve body Second Phonocardiogram hyperthyroidism accompanied by mild projectile systolic murmur. X-rays showed the ascending aorta local widened, expandable convex, aortic pulse contraction increased, sometimes in the aorta strips calcification. With aortic atherosclerosis, calcification occurs in the aortic arch, was massive. 2. syphilitic aortic insufficiency (syphiliticaorticregurgitatio n) syphilitic heart disease generally 10-25 years after infection to develop any symptoms and signs. Aortic insufficiency is the most common clinical type, in the case of aortic insufficiency, will be maintained for 5-6 years or more asymptomatic or only mildly alarmed and shortness of breath, or accompanied by angina, The latter often due to coronary artery stenosis. Once heart failure, the condition often rapid progress recurrent pulmonary edema, a serious threat to life. Physical examination often left heart voiced sector expanded sternum right edge of the second and third intercostal voiced sector widened, apexcardiogram increase. Auscultation in the sternum right edge of the second and third intercostal sternum and the left edge of the third, 4 intercostal have projectile systolic and diastolic murmur quarrels can be left armpit conduction. Apical area less often heard rumbling sexual diastolic murmur. Because of this aortic insufficiency reflux attack are being opened to the mitral anterior leaflet, produced relative caused mitral stenosis. This also called Austin-Flint murmur murmur with rheumatic mitral stenosis is different. The former is not associated with the first heart sound apical area open valve hyperthyroidism or sound, nor systolic enhanced greatly. Aortic valve in the first, two areas auscultation heard projectile systolic murmur, mainly due to aortic expansion. Early in the regular contraction increased. and rheumatic aortic stenosis and insufficiency generated more noise in the late contraction increased, accompanied neck or sternum right edge of the second intercostal systolic tremor. Second aortic heart sounds hyperthyroidism, as the weakening or disappearance of aortic valve disease involving the extent to which. Inflammation involved only aortic valve, aortic valve area second heart sound hyperthyroidism; aortic valve lesions were fibrous or change activity weakened valve, aortic valve area second heart sound weakened or disappeared, apical region heart failure can hear diastolic Benma law. Aortic insufficiency heavier, sometimes accompanied by increased pulse pressure, peripheral arterial, there will be the shot noise, capillary and arterial pulsation Department return murmur (Duroziez levy), peripheral vascular signs. X-ray examination showed cardiac under the left rear increased heart shoe was available, the limitations of the ascending aorta was expanding, ECG showed left ventricular hypertrophy, the Left Alliance have ST-segment depression and T-wave inversion. 3. syphilitic coronary stenosis (SyphiliticStenosisofCoronaryO ística) associated with the aortic insufficiency exist. Since coronary stenosis occurred slowly, often rich coronary collateral circulation; Therefore, Early patients with no obvious symptoms can be. Coronary artery stenosis occurred slowly, coronary stenosis severe angina may occur, Some of the patients developed symptoms died a short time later. The incidence of myocardial infarction lower, but with coronary atherosclerosis, myocardial infarction higher rate of incidence. 4. syphilitic aortic aneurysm (syphiliticaorticaneurysm) syphilitic aortic aneurysm Because of its location, with different clinical manifestations, clinical more common following categories : (1) or aortic aneurysm known as signs of aortic aneurysm, or aortic aneurysm often ahead and the expansion of the upper right, in the course of aortic aneurysm can increase asymptomatic, although there are obvious signs, symptoms but still very significant. Ascending aortic aneurysm expansion move may trigger sternum right edge of the first, two intercostal partial uplift and pulsate; Aneurysms can be expanded oppression right superior vena cava and the emerging face, upper extremity edema and bruising, chest computed vein, compression of the right bronchus and right lung caused shortness of breath and copper sound like cough, often accompanied by pulmonary infection, Occasionally, the pulmonary artery pressure and pulmonary stenosis have the signs and symptoms. Ascending aortic aneurysm such as nerve compression, ribs or sternum, there will be chest pain. Enlargement of aneurysm rupture occurred, such as aneurysm ruptured into the pulmonary artery, there will be a similar patent ductus arteriosus continuity noises. If breaking into the pericardial cavity can occur in acute cardiac tamponade symptoms and signs of breaking into the chest of sudden death. (2) aortic arch aneurysms are called symptomatic aortic aneurysm. As the aortic arch aneurysm can occur early in the surrounding structure of oppression and developed symptoms. If aneurysms, there will be oppression esophageal dysphagia; Superior vena cava pressure appeared to her face, chest and upper extremity edema venous engorgement; Cong oppression, there will be sympathetic side Miosis and (or) the side of the skin and sweat-free; Left recurrent laryngeal nerve compression may appear hoarseness; phrenic nerve compression may appear belch inverse and chest pain. Left bronchial compression can cause asthma and copper-like cough, bronchial stenosis can occur atelectasis and recurrent pulmonary infections. Aneurysm to the chest as prominent, visible body check local uplift is chest beating. Heart no general expansion in ascending aortic aneurysm site systolic murmur can be heard. pulmonary venous pressure and azygos vein, there may be signs of pleural effusion. Aortic arch aneurysm rupture of a small number of patients also means a lot of hemoptysis trachea and died of suffocation. (3) Aortic Aneurysm three aortic sinus aneurysm can occur, tumor growth, convex into the heart, to gradually increase, oppression can be dealt near the right ventricular outflow tract obstruction and aortic insufficiency, atrioventricular block or coronary thrombosis. When the tumor has not been broken, have no obvious symptoms, can be heart palpitations, chest pain, angina, atrioventricular block or aortic insufficiency and right ventricular outflow tract obstruction symptoms and signs. Gradually thinning wall of the aneurysm can rupture into the right atrium, right ventricle; Pulmonary artery, left atrium, left ventricle, or pericardial cavity. With a right aortic sinus aneurysm ruptured into the right ventricle most common. Pulmonary aneurysm ruptured into the right ventricle or right atrium and the left edge of the third sternum, 4 intercostal continuity heard loud noises like machines can touch small tremor, increased heart voiced sector, blood pressure can reduce diastolic blood pressure, pulse pressure, along with veins and capillaries of water will pulsate. (4) descending aortic aneurysms can be asymptomatic or early signs. Large aneurysm as oppression can lead to esophageal dysphagia, oppression, there will be the bronchial cough, short breath and repeated respiratory infections, oppression or thoracic ribs have severe chest pain, chest wall can be seen after the beating. (5) abdominal aortic aneurysm less see. Oppression spinal aneurysm or other organs can be sustained or paroxysmal abdominal pain. Check-in location of tumor can be touched beat accompanied by small tremor. 5. Myocardial syphilitic aneurysm (syphiliticgummaofmyocardium) mainly myocardial gum-like change, the more common diseases of limitations in the left ventricular septal can no symptoms. If the tumor is located in the bundle or bundle branch spaces, ECG can be left bundle branch block, myocardial large gum-like blooms, can lead to false mitral stenosis, there will be corresponding symptoms and signs, diffuse kind of gum can change the heart increases markedly, Recalcitrant ultimately heart failure.