CARDIAC MANIFESTATIONS IN PATIENTS WITH ANKYLOSING SPONDYLITIS

Cardiac involvement in ankylosing spondylitis may be clinically quiet or may cause considerable problems. Some of the most common cardiovascular manifestations observed in AS are: valvular disease, conduction disturbances and congestive heart failure due to decreased ventricular function. This study aims to determine the prevalence of cardiac disorders in AS patients with high disease activity. This is a cross sectional study of 42 patients diagnosed with ankylosing spondylitis. All patients received complete physical examination with a heart and lung auscultation and an electro-cardiogram (ECG) to identify conduction disturbances and echocardiography to identify structural disorders. The study included 38 men and 4 women, with a gender ratio of 9.5. The average age of onset was 23±5 years. In the majority of cases the disease followed axial involvement first (low back pain and/or buttock). The extra-articular manifestations were present in 52% of cases. 10 patients showed cardiovascular involvement - 2 patients showed aortal regurgitation, five patients had mitral regurgitation, two patients had left anterior hemiblock and one had atrial fibrillation, one patient presented an array of pulmonary insufficiency. The average time of onset of cardiac involvement was 9±4 years. Cardiac involvement in ankylosing spondylitis is seen more frequently in men, especially in the old cases. The most common disorders are valvular disorders (aortic, mitral and tricuspid insufficiency) and conduction disturbances (left anterior hemiblock, right bundle branch block, sinus bradycardia, and atrial fibrillation). Patients with AS should be screened with echocardiography and electrocardiography.