Syphilitic coronary stenosis,with myocardial infarction

The protocols of 6,225 consecutive autopsies at the Charity Hospital of New Orleans during the past five years were reviewed in order to ascertain the incidence of myocardial infarction secondary to syphilitic coronary stenosis. Three such patients were found. These comprised 1.6 per cent of all cases of myocardial infarction. A review of the literature revealed nine other patients with myocardial infarction caused by syphilis.The average age of the patients with syphilitic coronary stenosis was forty-five years. Both arteries were involved in the majority of cases. Among the patients with coronary stenosis, the white to colored ratio was about one to six, and the female to male ratio was about one to three and a half. The blood Wassermann reaction was positive in 96.3 per cent of the patients with coronary stenosis. The average weight of the hearts with coronary stenosis alone was 413 grams, whereas patients who had had coronary stenosis and aortic regurgitation, hypertension, or both, had an average heart weight of 680 grams.A case of myocardial infarction secondary to syphilitic coronary stenosis was described to illustrate the clinical picture.