Aortic valve incompetence and replacement in rheumatoid arthritis.

Annals of the Rheumatic Diseases
J M IvesonV Wright

Abstract

Five cases of aortic incompetence and nodular seropositive rheumatoid arthritis are presented. Four cases underwent aortic valve replacement. Two of these had granulomatous involvement of the aortic cusps similar to subcutaneous rheumatoid nodules, and another showed a nonspecific fibrosis. One case had definite coincidental rheumatic aortic and mitral heart disease. Two patients had undergone pericardectomy previously for constrictive pericarditis. Good results were obtained in all four operated cases and cardiac surgery enabled continuation of rehabilitation for the rheumatoid arthritis, including major orthopaedic procedures. A review of 22 cases from the literature with rheumatoid granulomata within the aortic valve shows that they are associated with mitral valve granulomata in 63-6%. Congestive cardiac failure was found in 75%. Macroscopical evidence of aortic incompetence was seen in 36-8% and of aortic stenosis in 15-8%. Associated pericarditis occurred in 59-1%, which was severe or complicated in 13.6%. The associated arthritis was severe in 77-8% with subcutaneous nodules (71-5%), rheumatoid factor (83-6%), and episcleritis (66-6%). From these cases and a review of the literature the following points are emphasized. (...Continue Reading

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Citations

Jun 1, 1979·Arthritis and Rheumatism·A M NomeirL E Watts
Oct 27, 2005·Clinical Rheumatology·Juan-Manuel Anaya
Oct 1, 1975·Annals of the Rheumatic Diseases·P J RooneyR Railton
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Mar 13, 2019·Disease Models & Mechanisms·Chandan SangheraSusanne Sattler
Jul 3, 2021·Journal of Clinical Medicine·Markus MalmbergVille Kytö

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