二尖瓣炎作为类风湿关节炎的一种严重关节外表现：一例报告
Mitral valvulitis as a severe extra-articular manifestation of rheumatoid arthritis: a case report.
作者信息
Frederiksen Anne Sofie, Jørgensen Steen Hylgaard, Wiggers Henrik, Hauge Ellen-Margrethe
机构信息
Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark.
出版信息
Eur Heart J Case Rep. 2021 Jan 15;5(1):ytaa467. doi: 10.1093/ehjcr/ytaa467. eCollection 2021 Jan.
BACKGROUND
Extra-articular manifestations (EAMs) are common in patients with rheumatoid arthritis (RA). Cardiac EAMs are rare but may cause complete heart block and damage to the heart valves.
CASE SUMMARY
We present the case of a middle-aged woman with long-standing RA and EAMs as the most prominent symptoms. The patient experienced complete atrioventricular heart block and developed nodular vegetations affecting the mitral valve, ultimately leading to severe mitral regurgitation and valve replacement.
DISCUSSION
The diagnosis of cardiac EAMs in RA may be challenging for the clinicians. Symptoms and findings may mimic more common conditions such as malignancy and infectious endocarditis. A multidisciplinary approach is of paramount importance in order to make an early diagnosis and to provide optimal treatment to patients with RA and cardiac complications.
背景
关节外表现（EAMs）在类风湿关节炎（RA）患者中很常见。心脏关节外表现罕见，但可能导致完全性心脏传导阻滞和心脏瓣膜损害。
病例摘要
我们报告了一例中年女性病例，该患者患有长期类风湿关节炎，以关节外表现为最突出症状。患者出现完全性房室传导阻滞，并出现影响二尖瓣的结节状赘生物，最终导致严重二尖瓣反流和瓣膜置换。
讨论
类风湿关节炎患者心脏关节外表现的诊断对临床医生而言可能具有挑战性。症状和检查结果可能类似于更常见的疾病，如恶性肿瘤和感染性心内膜炎。多学科方法对于早期诊断以及为患有类风湿关节炎和心脏并发症的患者提供最佳治疗至关重要。
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