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[Aortic valve insufficiency in Crohn disease]
A Wäckerlin1, G Zünd, M Maggiorini
1Departement Innere Medizin, Universitätsspital Zürich.
Schweizerische Medizinische Wochenschrift
|May 31, 1997
Summary
Crohn's disease can cause severe heart problems, including aortic regurgitation and aortitis, leading to cardiogenic shock. Early diagnosis and aortic valve replacement are crucial for managing this rare cardiac manifestation.
Area of Science:
- Cardiology
- Gastroenterology
- Pathology
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease with known extraintestinal manifestations.
- Cardiac involvement in CD is rare, but this case highlights a severe presentation.
Observation:
- A 39-year-old man with CD presented with cardiogenic shock due to severe aortic regurgitation.
- Echocardiography revealed aortic root and ascending aorta dilation.
- Histology of the explanted aortic valve and aorta showed chronic aortitis.
Findings:
- The patient underwent successful aortic valve replacement.
- Post-surgery, left ventricular ejection fraction improved significantly.
- Histological findings suggested an HLA B27-related aortitis, potentially linked to Crohn's disease.
Implications:
- This case suggests aortitis near the aortic valve may be an extraintestinal cardiac manifestation of Crohn's disease.
- Ongoing aortic root destruction is possible, necessitating regular echocardiographic monitoring.
- Further research is needed to understand the link between CD and this specific type of aortitis.