The diagnosis of cardiovascular syphilis is often challenging and requires a combination of clinical, serological, and histological findings. Clinically, patients may present with symptoms related to aortic aneurysms or aortic valve insufficiency, such as chest pain, shortness of breath, and heart failure. Serological tests, such as the rapid plasma reagin (RPR) test and the fluorescent treponemal antibody absorption (FTA-ABS) test, are used to detect antibodies against Treponema pallidum. However, these tests are not specific for cardiovascular syphilis and must be interpreted in conjunction with clinical and histological findings. Histological examination remains a crucial component of the diagnosis. Biopsy samples from the affected aortic tissue can reveal the characteristic inflammatory and degenerative changes described earlier. Special staining techniques, such as the Warthin-Starry stain, can also be used to identify the presence of spirochetes in the tissue.
