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Acute fulminant aortic and mitral insufficiency in ankylosing spondylitis.

EXTRASKELETAL manifestations of ankylosing spondylitis include aortitis with aortic1 , 2 and rarely mitral3 , 4 valvular insufficiency. Cardiac dysfunction usually develops late and progresses slowly.1 The acute case of aortitis presented below required emergency bivalvular replacement antedating spondylitis. Case Report A 16-year-old boy was admitted to Sacramento Medical Center, on August 10, 1971, with a three-week history of exertional dyspnea, constitutional symptoms and a 4-kg weight loss. The history was negative for previous murmurs. The blood pressure was 120/50 mm Hg, the pulse 90, and the temperature 37.0°C. The precordium was hyperactive, with a Grade IV of VI harsh systolic murmur at the . . .