Giant Syphilitic Ascending Aortic Anuerysm

Aneurysms are usually defined as a localized dilation of an arterial segment greater that 50% its normal diameter. The occurrence and expansion of an aneurysm in a given segment of the artery involves local hemodynamic factors. Aneurysmal degeneration occurs more commonly in the aging population. Ascending aortic aneurysm is the second most common aortic aneurysm after abdominal aortic aneursyms. Most ascending aortic aneurysm is diagnosed in sixth or seventh decade of life. Patient with connective tissue disorder and bicuspid aortic valve are diagnosed earlier in life. Ascending aortic aneurysms can involve proximally from the aortic annulus and can extend distally till the innominate artery. They may compress or erode into the sternum and ribs, superior vena cava or airway. They can rupture or dissect involving the pericardium, aortic valve, or coronary arteries. We report a case of gross ascending aortic anuersym who presented with Dyspnoea NYHA class III and chest pain since six months. Options of surgery were discussed with patient's relatives. But, the patient and her relatives were reluctant to give consent for surgery. Hence, Patient is on conservative management.