Lone aortic insufficiency and conduction disease: A marker of reactive arthritis

Joshua M. Lader, Geoffrey Lam, Robert Donnino, Edward S. Katz, Abe DeAnda, Mark Ettel, Muhamed Saric

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


A 48-year-old male with history of chronic arthritis and uveitis presented with 1 year of progressively reduced exercise capacity and nonexertional chest pain. Physical examination was consistent with severe aortic insufficiency. An electrocardiogram demonstrated sinus rhythm with first degree atrioventricular block. Transthoracic and transesophageal echocardiography demonstrated severe lone central aortic insufficiency of a trileaflet valve due to leaflet thickening, retraction of leaflet margins and mild aortic root dilation in the setting of left ventricular dilatation. In addition, computed tomographic angiography revealed a small focal aneurysm of the distal transverse arch. He was found to be positive for the immunogenetic marker HLA-B27. The patient subsequently underwent uncomplicated mechanical aortic valve replacement. The diagnosis of HLA-B27 associated cardiac disease should be entertained in any individual with lone aortic insufficiency, especially if accompanied by conduction disease. (Echocardiography 2014;31:E271-E274).

Original languageEnglish (US)
Pages (from-to)E271-E274
Issue number9
StatePublished - 2014
Externally publishedYes


  • Aortic insufficiency
  • HLA-B27
  • Reactive arthritis
  • Reiter's syndrome

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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