Rheumatoid involvement of the aortic arch

Area of Science:

• Cardiology
• Rheumatology
• Cardiac Surgery

Background:

• Rheumatoid arthritis (RA) can lead to cardiac complications, particularly valvular disease.
• Postmortem studies indicate high rates of rheumatoid involvement in the pericardium, myocardium, and valves.
• Clinical recognition of rheumatoid valvulitis is infrequent, possibly due to subtle symptoms in RA patients.

Purpose of the Study:

• To highlight the underdiagnosis of cardiac involvement in rheumatoid arthritis.
• To emphasize the importance of cardiac evaluation in RA patients.
• To present cases of successful aortic valve replacement for rheumatoid valvular disease.

Main Methods:

• Literature review to assess the prevalence of reported cases of rheumatoid valvulitis and aortic valve replacement.
• Clinical case presentation of two patients with rheumatoid valvular disease who underwent aortic valve replacement.

Main Results:

• A significant discrepancy exists between postmortem findings of rheumatoid valvular disease and reported clinical cases.
• Two patients with rheumatoid valvular disease experienced positive outcomes following aortic valve replacement.
• Timely surgical intervention can prevent left ventricular dysfunction.

Conclusions:

• Cardiac evaluation is crucial for patients with rheumatoid arthritis to detect significant valvular involvement.
• Aortic valve replacement is a viable option for managing severe rheumatoid valvulitis.
• Early intervention can improve outcomes and prevent irreversible cardiac damage in RA patients with valvular disease.