In an article he wrote for the January / February 2005 issue of Spondylitis Plus entitled, "The Heart in Spondylitis", Dr. Norton Hadler wrote, "Unfortunately, having AS does not spare one the risk of more common diseases, including the usual types of cardiovascular disease."

A recent review of data from patients enrolled an "integrated outcomes database" have shown that "cardiovascular diseases and their risk factors were more common in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis," than in those without these diseases.

A small number of people with spondylitis will display signs of chronic inflammation in the base of the heart - around the aortic valve and origin of the aorta (i.e. that vessel which takes all blood from the heart to be distributed throughout the body). Years of chronic and silent inflammation at these sites can eventually lead to heart block and valve leakage, sometimes requiring surgical treatment. Although recognized, these cardiac lesions probably are seen in fewer than two percent of all patients with spondylitis, and nearly always in males. The lesions are readily detectable by the physician's examination and when necessary, cardiac testing.

Also, adults with spondylitis often have chest pain that mimics the heavy chest pain of cardiac angina or pleurisy (the pain with deep breathing that occurs when the outer lining of the lung is inflamed). Anyone experiencing symptoms should seek medical attention to rule out a more serious condition. What often happens, over time, is that the joints between the ribs and spine, and where the ribs meet the breastbone in front of the chest, develop decreased chest expansion because of long-term inflammation and scarring of the tissues. If the pain is found to be spondylitis-related and you find yourself unable to practice the critical deep breathing exercises, which help maintain chest expansion, there are things that you can do to help yourself:

• Use ice packs on the affected areas for short periods
• Try gentle massage of the neck and shoulder area
• Try deep breathing exercises after a hot shower or warm bath

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