From the Guidelines
Ankylosing spondylitis can indeed cause heart-related complications, most commonly affecting the aorta and heart valves, with aortitis and aortic regurgitation being the most frequent cardiac manifestations, as noted in the 2017 study by 1. The cardiac complications associated with Ankylosing Spondylitis (AS) are a significant concern, as they can lead to increased morbidity and mortality.
- The inflammation that characterizes ankylosing spondylitis can spread to the heart, particularly affecting the aortic root and valve, leading to aortic valve thickening and regurgitation.
- Patients may also develop conduction abnormalities like heart blocks, myocardial dysfunction, and have an increased risk of atherosclerosis, as mentioned in the 2019 update by 1.
- Regular cardiac monitoring is recommended for ankylosing spondylitis patients, including echocardiograms every 3-5 years even without symptoms, to detect any potential cardiac issues early on.
- Treatment focuses on controlling the underlying inflammation with NSAIDs, TNF inhibitors like adalimumab or etanercept, or IL-17 inhibitors like secukinumab, as suggested by the 2016 recommendations by 1 and 1.
- These medications help reduce both joint and potential cardiac inflammation, and patients should also manage cardiovascular risk factors through regular exercise, healthy diet, blood pressure control, and avoiding smoking.
- Any new symptoms like chest pain, shortness of breath, palpitations, or fainting should prompt immediate medical attention, as they may indicate a cardiac complication. The most recent and highest quality study, 1, provides the most up-to-date guidance on the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis, and its recommendations should be prioritized in clinical practice.
From the Research
Cardiac Complications Associated with Ankylosing Spondylitis (AS)
- There is limited information available on the cardiac complications associated with Ankylosing Spondylitis (AS) in the provided studies.
- One study mentions that AS "may also affect the eyes, heart and lungs" 2, but it does not provide further details on the cardiac complications.
- The other studies focus on the treatment and management of AS, including the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor inhibitors (TNFi), but do not discuss cardiac complications 3, 4, 5, 6.
- Therefore, based on the available evidence, there is limited information on the cardiac complications associated with AS.