Rheumatoid Inflammation Causing Aortic Valve Perforation

Abstract

An elderly woman with rheumatoid arthritis presented with progressive dyspnea. Transoesophageal echocardiography revealed severe aortic regurgitation with perforation of the non-coronary and left coronary leaflet. After stabilization and a week of antibiotic therapy, aortic valve replacement was performed. The valve histology showed palisading granulomas typical of rheumatoid etiology.