29th September 2020

A woman with a 13-year history of Ankylosing Spondylitis presents to the A+E department

A woman with a 13-year history of Ankylosing Spondylitis presents to the A+E department with a 3-day history of epigastric pain, fatigue and shortness of breath. O/E: HR: 112, RR: 24, Temperature: 38.5 degrees, SaO₂: 96% on room air, weak radial pulse bilaterally. When prompted, she reports that she has been more fatigued recently and “blacked out” at the supermarket for a few seconds last week. 

For the description above, please match the SINGLE most likely clinical manifestation of Ankylosing Spondylitis. Select ONE option from the list above.