COMPLETE HEART BLOCK AND AORTIC INSUFFICIENCY IN RHEUMATOID SPONDYLITIS

The clinical and pathologic findings in a patient with complete heart block and aortic insufficiency associated with long-standing rheumatoid spondylitis are described. Aortic insufficiency was caused by shrunken aortic valve leaflets and dense scarring at the base of the aortic valve cusp. Histologically, the atrioventricular bundle was infiltrated by dense acellular scar tissue, and the atrioventricular bundle fibers were infiltrated with chronic inflammatory cells, thus leading to various atrioventricular conduction disturbances. Two additional clinical cases of complete heart block and aortic insufficiency in patients with rheumatoid spondylitis were treated with permanent transvenous pacemakers. © 1969.