Key result
A 38-year-old woman with rheumatoid arthritis successfully underwent mitral valve replacement after presenting with severe mitral regurgitation caused by a rare rheumatoid nodule on the anterior mitral leaflet.
Case Report (n=1)
Rheumatoid arthritis nodules can rarely involve the mitral valve leaflet, leading to perforation and severe mitral regurgitation requiring valve replacement.
May warrant considering rare RA valvular nodules in unexplained severe MR; leaves open prevalence, screening, and management questions.
Rheumatoid arthritis (RA) is a systemic disorder that is chronic in nature and difficult to treat. RA presents in many variants. Here we present an interesting case only seldom described before. Our patient presented to emergency room with acute shortness of breath and was seen to have acute pulmonary edema. Patient later had urgent echocardiography which revealed severe mitral regurgitation from ruptured anterior leaflet. Patient was taken for heart valve replacement and was found to have RA nodule on ruptured leaflet. There are cases involving aortic valve but to our knowledge there are no reports of RA nodule on mitral leaflet.
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Koneru et al. (2014) conducted a case report in Rheumatoid arthritis with severe mitral regurgitation (n=1). Mitral valve replacement was evaluated. A 38-year-old woman with rheumatoid arthritis successfully underwent mitral valve replacement after presenting with severe mitral regurgitation caused by a rare rheumatoid nodule on the anterior mitral leaflet.
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