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July 25, 1980

Psoriatic Arthritis and Aortic Regurgitation

JAMA. 1980;244(4):363-365. doi:10.1001/jama.1980.03310040045027

CARDIAC lesions involving pericardium, myocardium, vascular components, conduction tissue, and valves have been described in most of the rheumatic or connective-tissue diseases. In classic rheumatoid arthritis, all of the cardiac components mentioned previously may be involved.1-4 In ankylosing spondylitis, major cardiac involvement is usually limited to valvular and conduction tissue, with vascular, myocardial, and pericardial involvement occurring infrequently.3-6 Although ankylosing spondylitis and psoriatic arthritis share several similar clinical and serological features, reports of either myocardial dysfunction or the nature of the cardiac lesion in psoriasis are rare.3,6-8 We have recently seen a patient with long-standing HLA-B27-positive psoriatic arthritis who had chest pain and a new murmur of aortic regurgitation. Eventual surgical replacement of the aortic valve and histological examination of the resected native valve demonstrated pathological findings indistinguishable from those seen in ankylosing spondylitis.

Report of a Case  A 60-year-old man with a ten-year history of severe