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Atrioventricular (Heart) Block #283870 12/27/19 04:11 AM
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Sean O Offline OP
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Anyone been diagnosed with a heart block or atrioventricular block? It is a working diagnosis I have been given and it sometimes causes me to faint. Apparently it can be caused by AS theoretically.
My symptoms are usually that I get really woozy and lightheaded. This doesn’t happen frequently. I few times I have dropped from standing a (I don’t recommend fainting in the bathroom by the way even though if you feel really dizzy you might think of heading that way).


Male, mid 50s, Dx Reactive Arthritis 1981. AS+ 1991, HLA B27+, Tylenol 3 PRN for flares. Considering a biologic. SI and thoracic involvement and costochondritis. Many bouts of uveitis. Some bowel issues, anemia. Inflammation of the joints in hands and feet.
Re: Atrioventricular (Heart) Block [Re: Sean O] #283871 12/27/19 07:27 PM
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Winston Online
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I don't think it's merely theoretical that AS can cause AV block. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852774/ . Scroll down to the section on conduction abnormalities to find the discussion specific to AV node dysfunction. I found it particularly interesting that 20% of all patients implanted with permanent pacemakers are HLA-B27+.

Note that even the Spondylitis Association now recommends that all AS patients "should be screened with a physical exam, and an echocardiogram (a diagnostic test that may show abnormalities such as valve dysfunction or damage to heart tissue) annually to rule out any issues affecting the heart." https://www.spondylitis.org/Heart-in-Spondylitis

Re: Atrioventricular (Heart) Block [Re: Sean O] #283875 12/28/19 02:57 AM
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I developed SVT after 1 year on Remicade. That led to an ablation 3 years later which was successful. Since then I have had only one episode of SVT and it resolved with Diltiazem which I now take daily. Most of these electrical issues of the heart can be managed or fixed. However if a person has had a history of Tachyarrythmia or heart block, they would be wise to visit with a conscientious cardiologist prior to beginning therapy.


Diagnosed AS 2001.Remicade 2002 - 5mg/kg every 7 weeks.
Right Eye Trabeculectomy/lens replacement 2006 > DSEK Cornea Transplant 2009.
>Ahmed Shunt 2016 >DSEK Cornea Transplant 2016.
Supra Ventricular Tachycardia. Radio Frequency Ablation 2008.
Cardiac Stent to RCA 9/2020

ICU RN - Seattle, WA
~Grasp The Challenge and Succeed~
Re: Atrioventricular (Heart) Block [Re: Sean O] #284032 02/11/20 04:29 PM
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I was diagnosed with 3rd degree heart block soon after a bout with the shingles. I too almost fainted 3 times after a short walk across my yard before a trip to the ER. It's kinda scary not being able to catch your breath. My heart beat was 28 bpm when I arrived so the hospital kept me and now I have a pacemaker. My cardiologist recommended that I get an "MRI conditional" pacer because of AS so that I'm still able to get an MRI if needed - I've had 3 since the pacer was implanted. Keep that in mind if you need a pacemaker.


Paul
Re: Atrioventricular (Heart) Block [Re: Sean O] #284046 02/17/20 04:42 PM
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Hi all,
I’m on the forum today because at my rheumy visit earlier this month I reported to him what seemed to me was an incident of Costochondritis (chest pain when sleeping on my side). He scheduled me for a TTE-cardiac ultrasound, which I did not expect. After reading this thread, I'm concerned and thinking of all the times over the years that I thought I was having a heart attack. And all the times I've fainted and was told it was situational syncope. EGADS! I don't want to hijack Sean's post, I'm going to read the links above and am hoping more members will post on this thread. It helps me, I imagine it'll help Sean and others. Thank you all for the information.
Take care
Faye

Last edited by FayeK; 02/17/20 04:43 PM.
Re: Atrioventricular (Heart) Block [Re: Sean O] #284048 02/18/20 02:12 PM
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Winston Online
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Anyone who wants to read more about the connection between AS and cardiovascular disease should look at what the cardiologists, as well as the rheumatologists, are writing about it. Here are some more articles and abstracts:

https://www.ahajournals.org/doi/epub/10.1161/CIR.0b013e3181d4739e (see section 7.5 where AS is specifically identified as an inflammatory disease associated with thoracic aortic disease)

https://www.amjmed.com/article/S0002-9343(15)00443-X/fulltext

https://www.sciencedirect.com/science/article/pii/S0735109798003933?via%3Dihub

https://www.ncbi.nlm.nih.gov/pubmed/9809954

https://academic.oup.com/rheumatology/article/39/8/875/1784093

Re: Atrioventricular (Heart) Block [Re: Sean O] #284051 02/20/20 01:46 AM
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It has been interesting for me to watch the effect of AS and TNF on the cardiac system over 20 years. When I had SVT there was little information.

Now we have ways to speak about it. Watching this has been a textbook case of medical knowledge and it's growth over time.


Diagnosed AS 2001.Remicade 2002 - 5mg/kg every 7 weeks.
Right Eye Trabeculectomy/lens replacement 2006 > DSEK Cornea Transplant 2009.
>Ahmed Shunt 2016 >DSEK Cornea Transplant 2016.
Supra Ventricular Tachycardia. Radio Frequency Ablation 2008.
Cardiac Stent to RCA 9/2020

ICU RN - Seattle, WA
~Grasp The Challenge and Succeed~
Re: Atrioventricular (Heart) Block [Re: Sean O] #284055 02/20/20 03:44 PM
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achala Offline
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I suppose to go to a yearly cardio check up (for which I am already 6 months late) next week. Though not sure if to go as inflammation markers are down and don’t feel any heart related trouble. In the mri from 3 years ago been seeing some little scarring of left ventricular wall, which cardio played down saying this is my kind. CK kineaza and troponin are normal. All in all this cardio who is top cardio in the country I am based in see no connection AS & cardio.
Shall I still go? And how to approach this visit? Because I am tired explaining doctors that there is this research paper and that one...Thanks

Last edited by achala; 02/20/20 03:46 PM.

diagnosed with AS April 2018, starting with cervical pain/stiffness; Aug 2018 enthesitis/bursitis left Achilles
diagnosed with AAU Nov 2017 (7 flares so far)
Eosinophilic Gastritis
Sulfasalazine 3g 08.2018-05.2019 (worked for AAU & peripheral)
Supplements:C/D, omega 3/Probiotic/ Mediterranean NSD/curcumin
swimming/yoga/pilates
Predonisone in case of another AAU flare
Re: Atrioventricular (Heart) Block [Re: Sean O] #284056 02/20/20 04:37 PM
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Winston Online
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What's the harm in going? I don't know how things work in your country, but in the US, if a cardiologist wants to see you annually, it's because he or she thinks you are likely to develop a problem and/or wants to monitor something. Also, the point of checkups is to identify issues before they become problems. So waiting until an issue becomes symptomatic (i.e., evident to you) kinda defeats the purpose, doesn't it? Maybe if this checkup reveals nothing, ask the doctor if coming in every two or three years makes more sense for you.

As for how to deal with a cardiologist who doesn't believe in the connection between AS and cardiovascular disease, I don't think it really matters if he believes in the connection so long as he is performing the tests/procedures that would detect the damage that AS can cause.

Last edited by Winston; 02/20/20 04:37 PM. Reason: typo
Re: Atrioventricular (Heart) Block [Re: Winston] #284057 02/21/20 12:23 PM
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Originally Posted by Winston
What's the harm in going? I don't know how things work in your country, but in the US, if a cardiologist wants to see you annually, it's because he or she thinks you are likely to develop a problem and/or wants to monitor something. Also, the point of checkups is to identify issues before they become problems. So waiting until an issue becomes symptomatic (i.e., evident to you) kinda defeats the purpose, doesn't it? Maybe if this checkup reveals nothing, ask the doctor if coming in every two or three years makes more sense for you.

As for how to deal with a cardiologist who doesn't believe in the connection between AS and cardiovascular disease, I don't think it really matters if he believes in the connection so long as he is performing the tests/procedures that would detect the damage that AS can cause.



Excellent point!


AS/PsA DX in 1988

Retired on disability
in 2005 at age 44

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