What cardiovascular problem is associated with tertiary syphilis?

The cardiovascular problem associated with tertiary syphilis is aortitis. In tertiary syphilis, which occurs years after the initial infection, the disease can lead to systemic complications that affect various body systems, including the cardiovascular system. Specifically, aortitis results from chronic inflammation of the aorta, primarily affecting the ascending aorta and often leading to significant vascular changes such as dilation of the aorta.

This vascular involvement occurs due to the treponemes, the bacteria responsible for syphilis, inciting an immune response that leads to chronic inflammation. The complications of aortitis can include aortic regurgitation due to valvular involvement, aneurysm formation, and an increased risk of rupture.

In contrast, while myocarditis, pericarditis, and endocarditis can also occur due to various infectious causes, they are not characteristic manifestations of tertiary syphilis. Aortitis is the hallmark cardiovascular complication linked to this late stage of syphilis, making it the correct answer in this context.