Heart Block in Ankylosing Spondylitis

A DISTINCTIVE type of aortitis causing isolated aortic insufficiency in patients with ankylosing spondylitis has been the subject of several reports1-11since the association was first noted by Bauer et al in 1951.12Atrioventricular (A-V) and intraventricular conduction defects have been cited but seldom stressed.1,2,4-6,9,11,13The majority of cases has shown first degree atrioventricular block with an occasional left bundle branch block. There have been two reports of complete heart block. Bernstein13briefly reported two patients with aortic insufficiency and third degree block while Sobin and Hagstrom6demonstrated that the pathological process involved both the aortic root and the ventricular conduction system. Report of Cases Two cases of spondylitic aortitis with conduction defects were recently seen by us. Case 1 is the second case in the English language literature of proved pathologic involvement of the bundle of His in spondylitic aortitis associated with a conduction