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5 Early Signs Of Ankylosing Spondylitis
Early stages of ankylosing spondylitis may involve unexplained lower back pain and stiffness that come and go. Fatigue and pain in your heels, chest, and some joints are also possible symptoms.
Back pain is a top medical complaint. It's also a leading cause of missed work.
Possible causes of low back pain may vary and include trauma from a sudden strain on the spine. Unexplained back pain may sometimes signal a condition called ankylosing spondylitis (AS).
AS is a chronic autoimmune condition resulting from inflammation in the vertebrae of the spine. It's a form of spinal arthritis.
Not everyone with AS experiences early symptoms. When they do, symptoms may appear at any age between 20 and 40 years old. Children may also develop juvenile ankylosing spondylitis (JAS).
Early signs and symptoms of AS and JAS may include:
Unexplained pain in the lower backPain related to AS is often located in the sacroiliac joints. This is where your sacrum, the triangular bone at the bottom of your spine, and ilium, the upper hip bone, meet in the lower back.
Typical back pain often feels better after rest. AS may be the opposite. You may experience pain and stiffness upon waking or after resting.
In the same way, while exercise may make other types of back pain worse, AS symptoms may actually decrease after physical activity.
Lower back pain for no apparent reason isn't typical in younger people. Teens and young adults who complain of stiffness or pain in the lower back or hips may benefit from a medical consultation.
Unexplained stiffness and pain in other body partsPain in different areas of the body is also a common early symptom of AS and may include:
Tightness in the chest with difficulty breathing and stiffness after resting are also possible symptoms of AS.
Some people may experience pain in the hips and knees first, followed by lower back pain.
Pain that comes and goes but eventually worsensAS is a progressive disease. Although physical activity or pain medications may help temporarily, the condition gradually worsens.
At first, you may notice your symptoms come and go, but they won't stop completely. Stiffness and pain may be worse some days and then decrease in intensity.
As time passes, the pain may spread from the lower back to the rest of the spine.
If left untreated, AS may lead vertebrae to fuse, or grow together, causing a forward curvature of the upper spine called kyphosis.
Getting an early diagnosis and treatment may slow the intensity of the pain and kyphosis.
Pain that improves with movementExperiencing pain at night and feeling better once you get up is a common early symptom of AS.
At first, people with AS get symptomatic relief from taking common over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. However, these medications won't alter the course of the disease.
Changes in your bonesSlight damage to the tissues surrounding your cartilage and spine bones is an early sign of AS that may become obvious in X-rays.
Fusion of the bones between your hips and pelvis may start to happen. Inflammation may also lead to a "squaring" of your vertebrae, which could be seen in lateral X-rays of your spine.
It's also possible a radiologist notices deterioration of the corners of these bones.
AS is not the only condition that may lead to pain and stiffness that worsens with rest. These and other symptoms may have other causes, including:
Only a healthcare professional can provide an accurate diagnosis. If you have unexplained pain and stiffness that does not improve over time, consider consulting a healthcare professional for an assessment.
Typically, AS pain is dull and ongoing. Generally, you may feel some of the following:
In addition to pain, other AS symptoms may include:
Intermittent flare-ups of pain and stiffness in your spine are common in AS.
In the past, experts thought AS may be more common among young males, but new evidence indicates the condition is as common in males as in females.
Initial symptoms usually appear in the late teen to early adult years. AS can develop at any age, however.
The tendency to develop the disease is inherited. A genetic marker called HLA-B27 can indicate an increased chance of AS.
However, not everyone who develops AS has this gene. And when the gene is present, it doesn't mean you'll definitely develop AS.
It's unclear why some people get AS and others don't.
You may be more likely to develop AS if you have a close relative who lives with:
A history of genitourinary infections may also increase the risk of developing AS, according to the National Institute for Health and Care Excellence (NICE).
No single test exists for AS. Diagnosis may involve:
Some experts believe an MRI may be able to diagnose AS earlier than an X-ray because it can detect premature inflammatory changes in the affected joints.
However, this may not always be the case. It depends on your health needs, other test results, and proposed treatment decisions you and your healthcare team agree on.
If you find that your lower back pain (or pain in other joints) is lasting longer than you expected or you find that symptoms worsen with rest, you may want to contact a healthcare professional for testing.
AS has no known cure yet, but you can reduce your symptoms and slow the progression of the disease by:
Low back pain can have many causes. If it's a temporary symptom, low back pain could result from muscular tension, uncomfortable posture, lack of regular physical activity, a sprain, or a strain.
If your low back pain is persistent or comes and goes, causes may include ankylosing spondylitis, fibromyalgia, rheumatoid arthritis, other types of arthritis, herniated disks, tumors, or osteoporosis. Only a healthcare professional can provide an accurate diagnosis.
Where does ankylosing spondylitis pain start?It depends. Ankylosing spondylitis may begin as stiffness and pain in your lower back that comes and goes and may worsen after rest. Some people may also experience knee, ankle, and heel pain during the early stages of ankylosing spondylitis.
As the condition progresses, the pain may become more persistent and extend to the mid and upper back. You may also experience fatigue, eye irritation, and stiffness.
What is the average age of ankylosing spondylitis?The onset of ankylosing spondylitis is typically between 20 and 40 years, although you may develop the condition at any age.
What are the three most common symptoms of ankylosing spondylitis?Every body is different, but common early symptoms of ankylosing spondylitis include fatigue, low back pain, and stiffness.
As the condition progresses, you may also experience joint pain in other areas of the body, eye irritation, chest pain, gastrointestinal challenges, difficulty breathing, curving of the spine (kyphosis), and general back pain.
Ankylosing spondylitis (AS) is a progressive inflammatory condition that affects your spine and other body parts. Some people experience no early symptoms, while others may have lower back pain and stiffness that comes and goes.
AS pain usually decreases with physical activity and worsens at rest. Fatigue, gastrointestinal upset, and eye irritation may be early symptoms of AS.
Some symptoms common to AS may result from other conditions. Only a healthcare professional can offer you a comprehensive assessment and accurate diagnosis.
What Is Coronary Artery Occlusion?
Coronary artery occlusion is a partial or total blockage of one of the arteries in your heart. It can cause shortness of breath and chest pain but sometimes doesn't cause symptoms until you experience a complication, like a heart attack.
Your coronary arteries supply your heart with blood. Coronary artery occlusion is a partial or complete blockage of one of your coronary arteries, which can lead to a heart attack.
The underlying cause of coronary artery occlusion is usually coronary artery disease (CAD). CAD results from plaque buildup inside your coronary arteries, causing them to narrow. Pieces of this plaque can break off and lead to a blood clot and blockage inside your heart.
Read on to learn more about coronary artery occlusion, including symptoms, causes, and potential complications.
Coronary artery occlusion can prevent your heart tissue from receiving enough blood and oxygen. People with a partial blockage may only have symptoms with exercise, whereas people with total occlusion may always have symptoms such as:
Symptoms of a heart attackCoronary artery occlusion can lead to a heart attack. According to the Centers for Disease Control and Prevention (CDC), the major symptoms of a heart attack are:
Learn more about the early indications of a heart attack.
Coronary artery occlusion is usually a complication of CAD. Plaque inside your blood vessels, often developing over many years, leads to CAD by narrowing your coronary arteries and reducing blood flow.
Plaque can also break off your coronary arteries and lead to a blood clot that completely obstructs one of your coronary arteries.
Another cause of coronary artery occlusion is a coronary artery spasm, which is a temporary constriction (tightening) of the muscles inside your coronary arteries.
The risk factors of coronary artery occlusion are similar to those of CAD. These risk factors include:
The leading risk factor for coronary arterial spasms is smoking.
Doctors can typically make a diagnosis with a test called a coronary angiogram. During this test, your doctor injects a dye into your blood vessels, allowing blood flow to show up on an X-ray.
Doctors can grade the amount of blood flowing through your coronary artery on the following scale:
Another diagnostic tool is coronary computed tomography angiography (CCTA). It's a CT scan that looks specifically at your coronary arteries and can estimate the percentage of plaque buildup.
Other tests you might receive include:
Treatment for total coronary artery occlusion usually includes one of the following:
Doctors can often treat partial artery occlusion similarly to stable angina. They can prescribe beta-blockers to treat chest pain. Calcium channel blockers and long-acting nitrates are alternative treatment options.
A doctor will usually recommend lifestyle and dietary changes in combination with these treatments.
Coronary artery occlusion can lead to a heart attack if your heart doesn't receive an adequate supply of blood. A heart attack can lead to permanent scarring of your heart or death.
Your outlook with coronary artery occlusion depends on the severity of the blockage. Total occlusion is associated with a worse outlook and higher death rates.
In a small 2022 study, researchers examined the outcomes of people with chronic total coronary artery occlusion who received medications or PCI at an average follow-up of 56 months. They observed the following:
Here are some frequently asked questions people have about coronary occlusion.
What is the survival rate for right coronary artery blockage?In a 2021 study, researchers looked at the 10-year mortality rate for people who had received either PCI or a coronary bypass to treat a total occlusion. They found it ranged from 21.4–29.9%, depending on which treatment people received and whether they had a complete occlusion.
What are the warning signs of clogged arteries?Experts often consider CAD to be a silent disease because it may not cause symptoms until a significant blockage causes a heart attack. A type of chest pain called angina is often one of the first symptoms to appear.
Is a coronary occlusion a heart attack?Coronary occlusion is a partial or complete blockage of a coronary artery. This blockage can lead to a heart attack if your heart tissue can't receive enough blood.
Coronary occlusion is a total or partial blockage of one of the arteries that supply your heart with blood. It can lead to the death of heart tissue and a heart attack.
Doctors often treat a total coronary occlusion with a coronary bypass or PCI. Partial occlusions may be treatable with medications and lifestyle changes.
Carotid Stenting Can Help Patients With Silent Disease
Results from the largest-ever multi-center U.S. Registry on the efficacy of carotid stenting shows that the procedure is safe in patients who are at high risk for standard surgical therapy. The registry, an FDA-required post-approval study, known as CAPTURE (Carotid ACCULINK/ACCUNET Post Approval Trial to Uncover Rare Events) was presented today at the American College of Cardiology's 55th Annual Session in Atlanta. The multi-center study was led by Columbia University Medical Center researchers at NewYork-Presbyterian Hospital/Columbia.Patients with carotid artery blockage have an increased risk of stroke, even if they experience none of the disease's symptoms, which can include weakness, paralysis, visual problems or speech difficulties. The risk of stroke over five years in asymptomatic patients is about one in eight if carotid artery disease is treated only with medical therapy. The Center for Medicare and Medicaid Services currently does not cover carotid stenting for these asymptomatic patients, so many turn to surgery to clear blocked arteries. However, some patients are ineligible for surgery because of other medical conditions. In CAPTURE, the researchers collected data on 2,500 patients at increased risk for surgery. They were treated by 240 interventionalists at 188 medical centers across the country. All patients received Guidant's FDA-approved RX ACCULINK Carotid Stent System with RX ACCUNET Embolic Protection System. Neurologists otherwise unaffiliated with the study also evaluated patients immediately before and after stenting, and again 30 days later to judge the outcomes of the procedure.
Among asymptomatic patients, the trial found that the rate of major complications (death, stroke or heart attack) within 30 days of the stenting procedure was 5.7 percent, which is lower than the rate found in other studies of similar patients who undergo surgery. "The scope of this landmark trial provides us with a clear picture of the patients who benefit the most from carotid artery stenting. We hope these results will expand coverage to asymptomatic patients who are risky candidates for surgery," said William Gray, M.D., principal investigator on the study and associate professor of clinical medicine at Columbia University Medical Center and director of endovascular services at the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia and the Cardiovascular Research Foundation. Preliminary results on 1,600 patients in the CAPTURE trial were presented at the Cardiovascular Research Foundation's Transcatheter Cardiovascular Therapeutics (TCT) meeting in October 2005.
The results from the 2500 patients confirm the earlier suggestion that carotid artery stenting is highly beneficial for asymptomatic high-risk patients. The FDA approved carotid artery stenting for symptomatic patients following the pivotal ARCHeR trial, which enrolled a significantly smaller number of patients at centers with expert experience in carotid artery stenting. The larger CAPTURE trial was designed to determine the safety and efficacy of carotid stenting among a broader group of interventionalists with more variable levels of experience. At 5.7 percent, the CAPTURE trial had an even lower combined rate of death, stroke and heart attack than the ARCHeR trial, which had an 8.3 percent rate. The current study also looked for complications that might have gone undetected in the ARCHeR trial, but did not find any. The CAPTURE trial found that carotid artery stenting had better outcomes in younger patients. Stroke, death or heart attack occurred in 8.9 percent of patients over the age of 80, compared to 4.8 percent of patients under 80. The lowest percentage of adverse effects - 4.2 percent - were in asymptomatic patients under the age of 80.
It is anticipated that the positive results of this trial will support the re-examination, and eventual expansion, of current CMS reimbursement for this procedure and allow access to this promising technology for a greater number of beneficiaries.
In patients with carotid artery disease, the arteries that supply blood to the brain can develop atherosclerosis, a buildup of fat and cholesterol deposits, decreasing blood flow to the brain and increasing the risk of stroke. Approximately 25 percent of strokes are caused by carotid artery disease.
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Carotid artery stenting is a minimally invasive procedure that combines balloon angioplasty and a stent implant to unblock and reopen the carotid artery. Columbia University Medical Center provides international leadership in pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders in health care and includes the dedicated work of many physicians, scientists, nurses, dentists, and public health professionals at the College of Physicians & Surgeons, the College of Dental Medicine, the School of Nursing, the Mailman School of Public Health, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions.Columbia University Medical Center researchers are leading the discovery of novel therapies and advances to address a wide range of health conditions. Http://www.Cumc.Columbia.Edu NewYork-Presbyterian Hospital is the largest not-for-profit, non-sectarian hospital in the country. It provides state-of-the art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: New York-Presbyterian hospital/Columbia University Medical Center, New York-Presbyterian Hospital/Weill Cornell Medical Center, Children's Hospital of New York-Presbyterian, the Allen Pavilion, and the Westchester Division. It consistently ranks as one of the top hospitals in the country in U.S. News & World Report's guide to "America's Best Hospitals." The New York-Presbyterian Healthcare System – an affiliation of acute-care and community hospitals, long-term care facilities, ambulatory sites, and specialty institutes –serves one in four patients in the New York metropolitan area.
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The Cardiovascular Research Foundation is dedicated to research and education in the broad subspecialty of interventional cardiology and endovascular medicine. By establishing the safe use of new technologies and pharmacologic agents, CRF has for more than 15 years played a major role in the remarkable advances in survival and quality of life being realized for patients with cardiovascular disease. By collaborating with talented colleagues from around the world and through the development of innovative educational programs, CRF serves as a major catalyst in the field of interventional vascular medicine.
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