Mitral valvulitis as a severe extra-articular manifestation of rheumatoid arthritis: a case report

Author:

Frederiksen Anne Sofie1ORCID,Jørgensen Steen Hylgaard123ORCID,Wiggers Henrik12ORCID,Hauge Ellen-Margrethe24ORCID

Affiliation:

1. Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark

2. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark

3. Department of Cardiology, North Denmark Regional Hospital, Bispensgade 37, 9800, Hjoerring, Denmark

4. Department of Rheumatology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 59, 8200, Aarhus N, Denmark

Abstract

Abstract Background Extra-articular manifestations (EAMs) are common in patients with rheumatoid arthritis (RA). Cardiac EAMs are rare but may cause complete heart block and damage to the heart valves. Case summary We present the case of a middle-aged woman with long-standing RA and EAMs as the most prominent symptoms. The patient experienced complete atrioventricular heart block and developed nodular vegetations affecting the mitral valve, ultimately leading to severe mitral regurgitation and valve replacement. Discussion The diagnosis of cardiac EAMs in RA may be challenging for the clinicians. Symptoms and findings may mimic more common conditions such as malignancy and infectious endocarditis. A multidisciplinary approach is of paramount importance in order to make an early diagnosis and to provide optimal treatment to patients with RA and cardiac complications.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

Reference12 articles.

1. Rheumatoid arthritis;Scott;Lancet,2010

2. Extra-articular disease manifestations in rheumatoid arthritis: incidence trends and risk factors over 46 years;Turesson;Ann Rheum Dis,2003

3. Rheumatoid factor and antibodies to cyclic citrullinated peptides are associated with severe extraarticular manifestations in rheumatoid arthritis;Turesson;Ann Rheum Dis,2006

4. Occurrence of extraarticular disease manifestations is associated with excess mortality in a community based cohort of patients with rheumatoid arthritis;Turesson;J Rheumatol,2002

5. Cardiac involvement in rheumatoid disease;Kitas;Clin Med,2001

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