Title: Ankylosing spondylitis: An important cause of severe disturbances of the cardiac conduction system
Abstract: <h2>Abstract</h2> The cause of severe disturbances of the cardiac conduction system is seldom possible to establish clinically at pacemaker implantation, apart from cases of acute myocardial infarction or digitalis intoxication and in relatively rare cases of inflammatory disorders such as sarcoidosis and systemic sclerosis. Since cardiac manifestations, mainly conduction disturbances, occur in patients with ankylosing spondylitis, the prevalence of this disease was determined using radiologie screening for sacroillitis in a population of 223 men who had permanently implanted pacemakers. Sacroillitis was found in 19 men (8.5 percent), 15 of whom fulfilled the diagnostic criteria for ankylosing spondylitis. In six patients, sacroillitis was asymptomatic and two of the patients were completely free of symptoms other than those originating from their heart manifestations. In seven of the 15 patients with ankylosing spondylitis and in the four patients with sacroillitis without clinical criteria of ankylosing spondylitis, the diagnosis was previously unknown. Uveltis and aortic regurgitation occurred in five patients each, while peripheral arthritis was twice as common. The prevalence of sacroillitis and ankylosing spondylitis of 8.5 and 6.7 percent, respectively, differ significantly (p < 0.01) from the frequencies found in general Caucasian populations of 1 to 2 and 0.1 to 0.5 percent, respectively. HLA B27 was present in more than 80 percent of the patients with sacrolilltis and/or ankylosing spondylitis, compared with 8 to 10 percent in the general population. This strong association is in accordance with previous studies of patients with symptomatic sacroillitis and/or ankylosing spondylitis. Thus sacroillitis, diagnosed by x-ray, can be considered a marker for this relatively common rheumatic cause of severe disturbances of the cardiac conduction system.
Publication Year: 1982
Publication Date: 1982-08-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 75
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