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

Anne Sofie Frederiksen; Steen Hylgaard Jørgensen; Henrik Wiggers; Ellen-Margrethe Hauge

doi:10.1093/ehjcr/ytaa467

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

Anne Sofie Frederiksen^*, Steen Hylgaard Jørgensen, Henrik Wiggers, Ellen-Margrethe Hauge

^*Corresponding author for this work

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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.

Original language	English
Article number	ytaa467
Journal	European Heart Journal - Case Reports
Volume	5
Issue number	1
ISSN	2514-2119
DOIs	https://doi.org/10.1093/ehjcr/ytaa467
Publication status	Published - Jan 2021

Keywords

Autoimmune disease
Case report
Complication
Echocardiography
Endocarditis
Mitral regurgitation
Valvulitis

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10.1093/ehjcr/ytaa467Licence: CC BY-NC 4.0

Frederiksen et al (2021) Mitral valvulitis as a severe extra-articular manifestation of rheumatoid arthritisFinal published version, 506 KBLicence: CC BY-NC 4.0

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title = "Mitral valvulitis as a severe extra-articular manifestation of rheumatoid arthritis: a case report",

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.",

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author = "Frederiksen, {Anne Sofie} and J{\o}rgensen, {Steen Hylgaard} and Henrik Wiggers and Ellen-Margrethe Hauge",

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doi = "10.1093/ehjcr/ytaa467",

language = "English",

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T2 - a case report

AU - Frederiksen, Anne Sofie

AU - Jørgensen, Steen Hylgaard

AU - Wiggers, Henrik

AU - Hauge, Ellen-Margrethe

N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2021/1

Y1 - 2021/1

N2 - 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.

AB - 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.

KW - Autoimmune disease

KW - Case report

KW - Complication

KW - Echocardiography

KW - Endocarditis

KW - Mitral regurgitation

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

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