The clinical and anatomic findings of a patient with rheumatoid spondylitis, cardiac conduction disturbances, and aortitis with aortic insufficiency are presented. Postmortem examination showed, for the first time, destruction of the atrioventricular conduction bundle by lesions characteristic of rheumatoid disease. Because of the proximity of the root of the aorta to the atrioventricular conduction bundle, diseases of the root of the aorta can be expected to affect cardiac conduction. This case is further significant in that it provides a morphologic explanation for the association between rheumatoid spondylitis and cardiac conduction defects.
Sobin LH, Hagstrom JWC. Lesions of Cardiac Conduction Tissue in Rheumatoid Aortitis. JAMA. 1962;180(1):1-5. doi:10.1001/jama.1962.03050140003001