# Aortic Regurgitation in a Patient with Rheumatoid Arthritis/Systemic Lupus Erythematosus Overlap Syndrome (Rhupus): Case Report and Review of Literature

## TL;DR

A patient with rheumatoid arthritis and lupus developed aortic regurgitation, highlighting the need for heart monitoring in such patients.

## Contribution

This case report emphasizes the link between chronic inflammation in RA/SLE and aortic regurgitation as an extra-articular manifestation.

## Key findings

- A patient with RA/SLE overlap syndrome presented with moderate aortic regurgitation and preserved heart function.
- Chronic systemic inflammation in RA/SLE may contribute to the development of aortic regurgitation.
- Echocardiography is recommended for early detection of cardiovascular complications in rheumatologic patients.

## Abstract

Background/Objectives: Cardiovascular diseases (CVDs), including valvular heart disease (VHD), remain the leading cause of morbidity and mortality in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Case Presentation: We report a rare case of a woman in her fifth decade of life diagnosed with overlap syndrome (RA and SLE), in whom transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) revealed a degenerative altered bicuspid aortic valve with moderate aortic regurgitation (AR) and preserved left ventricular systolic function. The patient presented with a recent history of continuous, moderate chest discomfort and progressive exertional dyspnea, along with a mild elevation in highly cardioselective enzymes. AR was confirmed as the cause of her symptoms, rather than acute coronary syndrome or heart failure. Conclusions: This case highlights the potential contribution of chronic systemic inflammation in RA/SLE to the pathogenesis of AR, an extra-articular manifestation associated with adverse clinical outcomes. These findings support the routine use of echocadiography in rheumatologic patients as a key strategy for early detection and prevention of life-threatening CV complications.