Abstract

GALLEGOS-CAZORLA, Alex. Severe aortic regurgitation caused by rheumatoid arthritis with cardiogenic shock and death. Acta méd. peruana [online]. 2015, vol.32, n.2, pp.107-112. ISSN 1728-5917.

Rheumatoid arthritis (RA) frequently affects the heart with no hemodynamically significant valvular lesions. Severe secondary aortic regurgitation is rare, however it can progress rapidly and if not noticed in time endangers the patient's life. We present the case of a 45 year old woman with a history of RA diagnosed since age 25, admitted to hospital Daniel Alcides Carrión in Callao due to cardiogenic shock and RA not active. She reported two weeks of dry cough, dyspnea, and decubitus intolerance which progressively increased. Aortic diastolic murmur II / VI and aortic systolic ejection murmur II / VI were auscultated with thready Corrigan´s pulse. At admission BP was 60/30mmHg. Electrocardiogram showed left ventricular hypertrophy. Echocardiography reported dilated left ventricle with severe aortic regurgitation, moderate systolic dysfunction and moderate pulmonary hypertension. Shock was refractory to treatment and patient died 10 days after admission.

Keywords : Aortic valve insufficiency; Arthritis rheumatoid; Aortic valve; Shock cardiogenic.

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