SYPHILITIC aortic aneurysms may pursue a variety of courses and, although the condition is uncommon, rupture of an aortic aneurysm into the superior vena cava produces a quite dramatic clinical picture.
Hunter1 in 1757 discussed aortic aneurysms in the chest and arteriovenous aneurysms in the arm, but the first case of an aortic aneurysm rupturing into the superior vena cava was reported in 1833.2 A review of the literature from 1833 to the present time has disclosed a total of 117 cases.3 Three authors4 have presented excellent statistical analyses of the clinical and pathologic features. These reviews reveal that rupture of an aortic aneurysm into the superior vena cava usually occurs in males during the fourth or fifth decades. Symptoms begin with the sudden onset of a moderate to severe superior vena cava obstruction syndrome. Physical examination presents the striking appearance of moderately severe edema, venous distention, and cyanosis sharply