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April 1966

Pathology of the Cardiac Conduction System in Polyarteritis Nodosa

Author Affiliations


From the Department of Medicine, Henry Ford Hospital, Detroit.

Arch Intern Med. 1966;117(4):561-567. doi:10.1001/archinte.1966.03870100089016

THE HEART is often involved in polyarteritis nodosa and congestive failure is the second most frequent cause of death in this disease.1 Aneurysms of the coronary arteries were among the features first recognized in earlier studies 2 but are seen less often now; this is perhaps due in part to the effectiveness of anti-inflammatory therapy with adrenal corticosteroids. In a recent review of cardiac pathology observed in polyarteritis nodosa,3 the major manifestations were coronary arteritis (62%), myocardial infarction of various sizes (62%), and acute pericarditis (33%). Arrhythmias were described in only 9% and all these were supraventricular in origin; atrioventricular (AV) conduction disturbances were not reported. However, in the same series of patients tachycardia was present in 66%, being the second most frequent clinical cardiac finding.

Since the nutrient arteries of the sinus node and AV node are of the size (about 1 mm diameter) often involved