Starved for oxygen and nutrients, elastic fibers become patchy and smooth muscle cells die.

Additionally, in rare cases, chest pain and shortness of breath might appear as a result of the damage of the aorta and heart valve.

[citation needed] Inflammatory involvement of tertiary syphilis begins at the adventitia of the aortic arch which progressively causes obliterative endarteritis of the vasa vasorum.

[3] This leads to narrowing of the lumen of the vasa vasorum, causing ischemic injury of the medial aortic arch and then finally loss of elastic support and dilation of the vessel.

[4] In patients with aortic aneurysm, treatment would also involve surgical repair alongside intravenous penicillin, in order to reduce the likelihood of relapse.