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Congenital double mitral orifice with severe mitral regurgitation-associated rheumatoid arthritis: a case report
Huliurdurga Srinivasa Setty Natraj Setty1, Somanna Shankar1, Mogalahally Channabasappa Yeriswamy1
1Cardiology Department, Sri Jayadeva Institute of Cardiovascular Sciences and Research, #493, 4th Cross, 7th Main, J.P. Nagar 3rd Phase, Bangalore, Karnataka 560069, India.
Background:
A double orifice mitral valve (DOMV) represents a rare congenital malformation characterized by two valve orifices with two separate subvalvular apparatus. Double orifice mitral valve is congenital anomaly of the subvalvular mitral valve apparatus consisting of an accessory bridge of fibrous tissue, which partially or completely divides the mitral valve into two orifices.
Case Summary:
A 30-year young male presented with dyspnoea and palpitation for 4 years, joint pain for 2 years and weakness of right upper limb and lower limb for 6 months. On clinical examination, Boutonniere, Swan neck, and Z-deformity of hand and foot metatarsal bone deformities are noted, on further evaluation, patient was diagnosed as a case of DOMV and was managed conservatively since patient was not willing for surgery.
Discussion:
Two-dimensional echocardiography is the best detection method, the parasternal short-axis view being most useful to show DOMV.
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