{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:16:59Z","timestamp":1790295419664,"version":"4.1.0"},"reference-count":11,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,1,21]],"date-time":"2018-01-21T00:00:00Z","timestamp":1516492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:p>Aortitis is one of many possible manifestations of tertiary syphilis. Aortic disease is the most common of all cardiovascular syphilitic lesions. Aortic diseases caused by tertiary syphilis include aortitis, aortic root dilation, aneurysm formation, aortic regurgitation and coronary ostial stenosis. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We report a case of a 40\u2010year\u2010old male patient admitted with a clinical picture of acute coronary syndrome (unstable angina). He had no risk factors for coronary artery disease. The physical examination revealed nothing remarkable. The admission electrocardiogram (<jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content>) showed <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content> segment depression in the anterolateral and inferior leads (Figure\u00a01). The coronary angiogram showed critical ostial stenosis of the right (<jats:styled-content style=\"fixed-case\">RCA<\/jats:styled-content>) and left main coronary artery (Figure\u00a02a, b). Cardiac\u2010computed tomography showed aortic wall thickening with involvement of bilateral coronary ostia (Figure\u00a02b, c). The patient was referred for coronary bypass surgery after treatment with two doses of penicillin G. The laboratory test was strongly positive for syphilitic infection. Postoperative treatment with benzathine penicillin, in doses recommended for tertiary syphilis, was implemented.<\/jats:p>","DOI":"10.1111\/anec.12531","type":"journal-article","created":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T15:10:29Z","timestamp":1516633829000},"source":"Crossref","is-referenced-by-count":6,"title":["Acute coronary syndrome of very unusual etiology"],"prefix":"10.1111","volume":"23","author":[{"given":"Raimundo","family":"Barbosa\u2010Barros","sequence":"first","affiliation":[{"name":"Coronary Center of the Messejana's Hospital Dr. Carlos Alberto Studart Gomes  Fortaleza Cear\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4948-538X","authenticated-orcid":false,"given":"Andr\u00e9s R.","family":"P\u00e9rez\u2010Riera","sequence":"additional","affiliation":[{"name":"Laboratory Design of Studies and Scientific Writing ABC Faculty of Medicine ABC Foundation  Santo Andr\u00e9 S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimmo","family":"Koivula","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Life Sciences and Clinic of Internal medicine Helsinki University Hospital University of Tampere  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jairo","family":"de Carvalho Santos","sequence":"additional","affiliation":[{"name":"Coronary Center of the Messejana's Hospital Dr. Carlos Alberto Studart Gomes  Fortaleza Cear\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz C.","family":"de Abreu","sequence":"additional","affiliation":[{"name":"Laboratory Design of Studies and Scientific Writing ABC Faculty of Medicine ABC Foundation  Santo Andr\u00e9 S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell","family":"Nikus","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Life Sciences Heart Center Tampere University Hospital University of Tampere  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,21]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0365-05962006000200002"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052247"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.14.1582"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCA.0000000000000127"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000088337"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2009.07.009"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivr067"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.07.030"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2014.10.408"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1976.03270200044030"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1063788"}],"container-title":["Annals of Noninvasive Electrocardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fanec.12531","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anec.12531","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anec.12531","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anec.12531","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T19:38:40Z","timestamp":1694029120000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/anec.12531"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,21]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1111\/anec.12531"],"URL":"https:\/\/doi.org\/10.1111\/anec.12531","archive":["Portico"],"relation":{},"ISSN":["1082-720X","1542-474X"],"issn-type":[{"value":"1082-720X","type":"print"},{"value":"1542-474X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,21]]},"article-number":"e12531"}}