Clinical studies on involvement of the pulmonary artery by syphilitic aortic aneurysms.

Cardiac catheterization and angiocardiography studies are reported in two patients with syphilitic aortic aneurysms, both of which compromised the pulmonary circulation. In the first instance the right main pulmonary artery was compressed and pulmonary hypertension proximal to the compression resulted. In the second patient the aneurysm ruptured into the pulmonary artery producing an aortic-pulmonary fistula. This patient also had pulmonary hypertension and evidence at cardiac catheterization of a large left-to-right shunt. The difficulty of making the clinical diagnosis of pulmonary artery compression by an aortic aneurysm is discussed. Cardiac catheterization and angiocardiography were essential for establishing this diagnosis in life.