Heller-Döhle Syndrome: A Rare Case of Syphilitic Aortitis with Calified Ascending Aortic Aneurysm in an Elderly Lady

Background: Tertiary syphilis with cardiovascular complications are a rarity in the antibiotic era in developed nations although diagnoses of syphilitic aortitis is not uncommon in developing countries. It usually presents in the 4th to 5th decade of life and is unusual in the elderly. Aortic aneurysms and aortic regurgitation due to aortic root dilatation is the usual presentation. Nevertheless, it can remain undetected for the duration of its latent period which may extend upto 40 years and is often diagnosed on routine evaluation.Presentation of Case: We report a case of an 82 year old south indian lady who presented with clinical features of aortic regurgitation who was found to have a large calcified ascending aortic aneurysm with no neurological manifestations.Conclusion: We discuss the diagnostic challenge due to the unusually long latent period in our patient, the epidemiologic concerns, treatment options and possible complications