Highlights a rare complication of severe rheumatoid heart disease where hemorrhage into a cardiac nodule led to sinus of Valsalva rupture and complete heart block.
Rare rheumatoid cardiac complications merit consideration in atypical heart block; case report extends sparse literature without guiding practice.
A case is described ofgranulomatous rheumatoid heart disease with aortic regurgitation in which haemorrhage into a rheumatoid nodule caused rupture of the sinus of Valsalva and complete heart block.Rheumatoid arthritis may involve the heart.Cardiac nodules, identical histologically to those found in the subcutaneous tissues, were first described by Bagenstoss and Rosenberg A in I94I.Since then, some cases have been reported, including some with valve lesions 4 (Weintraub and Zvaifler, I963; Lassiter and
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Howell et al. (1972) studied this question.
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