[Double heart prosthesis in a patient with rheumatoid arthritis]

The incidence of rheumatoid valvular disease is among 2.5% to 30% of necropsy patients with rheumatoid arthritis. The valves may be affected by a granulomatous form patognomonic, or by unspecific inflammatory changes (the most frequent 90-99%). We present a patient affected by a classical seropositive rheumatoid arthritis accompanied by mixed stenosis and incompetence of both mitral and aortic valves. The patient underwent replacement of both valves, and typical unspecific inflammatory changes were detected histologically in the valvular tissues. Replacement of the valves by a prosthesis is the choice treatment despite severe joint disease. The echocardiography is the ideal method for detection of cases with subclinic lesions and to continue evolution.