Aorto-mitral inflammation in rheumatological disease: transoesophageal echocardiographic presentation

Thickening of the aortic root and anterior mitral leaflet has been described in patients with aortic valve insufficiency associated with ankylosing spondylitis. We report identical findings made by transthoracic and transoesophageal echocardiography in three patients with inflammatory, non-infective aorto-mitral pathology as manifestation of various rheumatological disorders. All three patients had significant aortic valve incompetence. All three had thickened walls of the sinuses of Valsalvae and a thickened anterior mitral leaflet, in one case with chordal rupture. These findings were confirmed at open heart surgery, and further characterized by histological examination.